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Feces Formation and Defecation01:26

Feces Formation and Defecation

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Updated: May 15, 2026

Movement Retraining using Real-time Feedback of Performance
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Published on: January 17, 2013

Biofeedback therapy for defecatory dysfunction: "real life" experience.

Daniela Jodorkovsky1, Kerry B Dunbar, Susan L Gearhart

  • 1Division of Gastroenterology & Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.

Journal of Clinical Gastroenterology
|January 19, 2013
PubMed
Summary
This summary is machine-generated.

Less than half of patients referred for biofeedback therapy (BF) complete treatment due to barriers like insurance and distance. However, real-world response rates for BF in dyssynergic defecation and fecal incontinence are comparable to clinical trials.

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Area of Science:

  • Gastroenterology
  • Pelvic Floor Rehabilitation
  • Colorectal Surgery

Background:

  • Biofeedback therapy (BF) is a recognized treatment for dyssynergic defecation and fecal incontinence (FI).
  • Clinical trials show high response rates (70-80% for dyssynergic defecation, 55-75% for FI).
  • Effectiveness of BF in routine clinical practice outside specialized centers is not well-established.

Purpose of the Study:

  • To determine the completion rate of BF referrals in a diverse patient population.
  • To identify barriers preventing patients from undergoing BF.
  • To assess the clinical response rate of BF in a real-world setting.

Main Methods:

  • Retrospective review of 203 patients undergoing anorectal manometry (2007-2010).
  • BF recommendation based on manometry findings (dyssynergy, sensation issues, sphincter function).
  • Clinical response assessed after a minimum of 5 BF sessions.

Main Results:

  • BF was recommended for 119 patients (58.6%), but only 48% with constipation and 44% with FI completed therapy.
  • Key barriers included lack of insurance, travel distance, and competing medical issues.
  • Subjective response rates were 60% for constipation and 80% for FI among those completing BF.
  • Patient demographics and BF location did not influence attendance or response.

Conclusions:

  • Less than half of patients recommended for BF in a heterogeneous population complete the therapy.
  • Real-world BF response rates are comparable to published clinical trial data.
  • Further prospective studies are needed to address barriers and optimize BF accessibility and outcomes.