Efficacy of Biofeedback Therapy in Patients With Dyssynergic Defecation: A Hospital-Based Study in Eastern India

Dyssynergic defecation, a disorder of the uncoordinated defecation process, is a common cause of chronic constipation. Biofeedback is a self-regulation technique where, based on visual feedback, patients learn coordination of the pelvic floor muscles. This study aims to evaluate the effectiveness of biofeedback therapy in patients with dyssynergic defecation.

In a prospective observational study carried out over a period of one year from June 2023 to May 2024 in patients diagnosed with dyssynergic defecation, biofeedback therapy sessions were given for 30 minutes to one hour per session every two weeks for a maximum of six sessions over three months. Improvements in the Bristol stool form scale, constipation scoring system, and/or quality of life (The Medical Outcomes Study Short Form-36 or SF-36) were used to assess the response to therapy.

Of the total 83 participants, 49 (59.04%) were male, and the median age was 43 years. Type I dyssynergia was the most common type. Thirty (36.1%), 37 (44.6%), and nine (10.8%) participants had improvement in Bristol stool form, constipation severity score, and SF-36 score, respectively. Bristol type 3 was the most common stool form at the first visit, while type 4 was the predominant stool form at the last visit. An improvement in Bristol stool form was seen in 30 (36.1%) participants. The average constipation scores at the first and last visits were 15.7±1.86 and 13.4±2.79, respectively (P<0.05), with improvement seen in 37 (44.6%) participants. The average SF-36 scores at the initiation of therapy and the last visit were 47.7±4.15 and 48.08±3.84, respectively (P>0.05), with improvement seen in only nine (10.8%) participants. Post-biofeedback therapy, an improvement in either of the three parameters, i.e., Bristol stool form, constipation severity score, or SF-36 score, was seen in 59 (71.1%) participants, of whom 37 (62.71%) responded to the therapy with two sessions.

Biofeedback therapy is beneficial in patients with dyssynergic defecation, with significant improvements in stool form and constipation-related symptoms.