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Biofeedback treatment for chronic constipation and encopresis in childhood: long-term outcome
1University of Iowa, Iowa City, USA.
Insights
Biofeedback training for children with chronic constipation and encopresis did not improve long-term recovery rates compared to conventional treatment alone. Learning normal defecation dynamics did not significantly enhance outcomes in the long run.
Area of Science:
- Pediatric Gastroenterology
- Clinical Outcomes Research
Background:
- Abnormal defecation dynamics are common in pediatric chronic constipation and encopresis.
- Biofeedback has shown short-term benefits for patients learning normal defecation dynamics.
Purpose of the Study:
- To assess the long-term effectiveness of biofeedback treatment in improving recovery rates for chronic constipation and encopresis in children.
- To compare long-term outcomes between conventional treatment and biofeedback-assisted conventional treatment.
Main Methods:
- A study involving 129 children diagnosed with constipation, encopresis, and abnormal defecation dynamics.
- Children received either conventional treatment or conventional treatment plus biofeedback training focused on normal defecation dynamics.
Main Results:
- Long-term follow-up (4.1 ± 1.5 years) showed similar improvement rates in encopresis for both groups (86% vs. 87%).
- Recovery rates from chronic constipation and encopresis were comparable between conventionally treated patients and those successfully treated with biofeedback (62% vs. 50%).
- Unsuccessful biofeedback treatment was associated with significantly lower recovery rates (23%), and longer follow-up duration correlated positively with recovery.
Conclusions:
- Biofeedback training, aimed at teaching normal defecation dynamics, did not yield superior long-term recovery rates for chronic constipation and encopresis in children compared to conventional treatment alone.
- The study suggests that while biofeedback may help some patients, it does not universally improve long-term outcomes beyond standard care.
- Longer follow-up periods are associated with better recovery, irrespective of the specific treatment modality.
Objective:
Abnormal defecation dynamics often are present in children with chronic constipation and encopresis. Patients who learned normal defecation dynamics with biofeedback treatment had improved short-term outcome. The aim of our research was to evaluate if biofeedback treatment improved long-term outcome.
Design:
One hundred twenty-nine children with constipation, encopresis, and abnormal defecation dynamics were treated conventionally; 63 of them received additional biofeedback training directed towards teaching normal defecation dynamics.
Results:
At follow-up (4.1 +/- 1.5 years), 86% of conventionally treated patients and 87% of biofeedback-treated patients had improvement in encopresis; 62% of conventionally treated patients, 50% of successful biofeedback-treated patients, and 23% of unsuccessful biofeedback-treated patients had recovered from chronic constipation and encopresis. Recovery rates were similar for conventionally treated patients and biofeedback-treated patients who learned normal defecation dynamics (P > .2) but significantly lower for unsuccessful biofeedback-treated patients (P < .02). Length of follow-up was significantly related to recovery (P < .01).
Conclusion:
Learning normal defecation dynamics with biofeedback training did not increase long-term recovery rates in children with chronic constipation, encopresis, and abnormal defecation dynamics above those achieved with conventional treatment alone.