Efficacy of home biofeedback in dyssynergic defaecation: A prospective pilot study

To evaluate the effectiveness of home biofeedback therapy in patients with dyssynergic defaecation.

This single-centre prospective cohort study was conducted in a tertiary general surgery outpatient clinic. Adult patients with dyssynergic defaecation confirmed according to Rome IV criteria and physiological testing were prospectively enrolled after ethical approval. Participants received training on the use of a home-based anal biofeedback device and performed biofeedback exercises at home for 30 min daily over a 12-week period. Changes in Obstructed Defaecation Syndrome Score (ODS-S) and Patient Assessment of Constipation Quality of Life (PAC-QoL) score were evaluated.

Twenty-four patients were included in the study. The median ODS-S significantly improved from 17.5 (range, 13-20) at baseline to 3 (range, 0-12) after treatment (P < 0.001). The median PAC-QoL score also showed a significant improvement, decreasing from 104 (range, 65-126) to 49 (range, 32-81) (P < 0.001). Clinical improvement, defined as an ODS-S < 9, was achieved in 75% of patients.

Home-based biofeedback therapy is an effective and accessible treatment option for dyssynergic defaecation. Its low cost, ease of use and ability to preserve patient privacy suggest that this modality may serve as a practical first-line therapy.