Three-dimensional high-resolution anorectal manometry can predict response to biofeedback therapy in defecation...

Area of Science:

• Gastroenterology and Hepatology
• Colorectal Surgery
• Pelvic Floor Disorders

Background:

• Biofeedback therapy (BT) is a standard treatment for outlet constipation and fecal incontinence.
• Despite its efficacy, a significant failure rate necessitates improved patient selection.
• High-resolution manometry (HRM) offers detailed anorectal function assessment.

Purpose of the Study:

• To investigate the predictive value of defecation disorder types, as classified by HRM, for biofeedback therapy response.
• To enhance patient selection for BT and improve treatment outcomes.
• To validate the utility of HRM in managing functional anorectal disorders.

Main Methods:

• Retrospective analysis of clinical, manometric, and ultrasound endoscopic data from 92 patients undergoing BT.
• Classification of patients into four defecation disorder types based on rectal pressure and anal contraction patterns.
• Standardized BT protocol with efficacy assessed via visual analog scale.

Main Results:

• Overall, 50.5% of patients responded to BT.
• Type IV defecation disorder was a significant predictor of BT success (OR=5.03).
• Type II defecation disorder predicted BT failure (OR=0.41), as did higher KESS score severity (OR=0.9).

Conclusions:

• Defecation disorder types identified by HRM are predictive of biofeedback therapy response.
• HRM plays a crucial role in the therapeutic management of anorectal functional disorders.
• This classification aids in selecting patients likely to benefit from BT, optimizing treatment strategies.