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ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders
S S C Rao1, M A Benninga, A E Bharucha
1Section of Gastroenterology/Hepatology, Georgia Regents University, Augusta, GA, USA.
Neurogastroenterology and Motility
|April 2, 2015
Summary
Biofeedback therapy is recommended for constipation with dyssynergic defecation and fecal incontinence in adults. Evidence does not support its use for childhood constipation.
Area of Science:
- Gastroenterology and Colorectal Surgery
- Pelvic Floor Dysfunction
- Biofeedback Therapy
Background:
- Anorectal disorders are common in adults and children.
- Biofeedback therapy has emerged as a safe treatment option.
- Clinical efficacy and techniques require critical appraisal.
Framework:
- Task force convened by the American Neurogastroenterology and Motility Society and the European Society of Neurogastroenterology and Motility.
- Examined indications, performance characteristics, methodologies, and efficacy.
- Provided evidence-based recommendations.
Implementation:
- Recommended for constipation with dyssynergic defecation (Level I, Grade A).
- Recommended for fecal incontinence (Level II, Grade B).
- May be useful for Levator Ani Syndrome and solitary rectal ulcer syndrome with dyssynergic defecation (Level II-III, Grade B-C).
Implications:
- Biofeedback therapy is effective for specific adult anorectal disorders.
- Evidence does not support its use in childhood constipation (Level 1, Grade D).
- Further research may clarify optimal techniques and outcomes.
