Effect of biofeedback therapy on dyssynergic constipation: a cross-sectional study
Abstract
Dyssynergic defecation disorder is among the most common group that does not respond to initial treatments and includes up to 50% of referrals to colorectal surgeons and gastroenterologists. The aim of this study is the evaluation of biofeedback therapy effects on dyssynergic constipation.
Materials and Methods: This research was a longitudinal study. During this project, 120 outpatients who visited the gastroenterology clinic of Imam Reza and Sheikh Al-Raees Hospital in Tabriz between 2022-24 for the treatment of dyssynergic constipation were examined after obtaining informed consent from the project process. The sampling method was accessible or easy. Patients underwent biofeedback training and treatment for 8 sessions (one training session and seven treatment sessions once a week). These trainings were conducted by trained doctors and nurses. Before starting the process of biofeedback therapy, the patient's clinical condition was evaluated and scored using a standard approved questionnaire, then after the 4th session and after the 8th session, the patient's condition was again evaluated and the clinical changes of the patient were compared and analyzed with scored criteria. Patients with dyssynergic constipation were classified into 4 categories. Symptoms related to dysenergetic constipation included the medication to evacuation (enemas or suppositories), difficulties to evacuate, digitation to evacuate, returning to the toilet to evacuate, feeling of incomplete evacuation, straining for evacuation, needing time for evacuation, lifestyle alteration and rectal bleeding, for each of these symptoms, the patient was asked to give a score of 0 to 3, and then the average score was calculated for each patient.
Results: In this study, the frequency of dysnergic constipation was in the studied subjects, 42 people (35.0%) first type, 46 people (38.3%) second type, 20 people (16.7%) third type and 12 people (10.0%) fourth type. Among the scores of constipation criteria after biofeedback treatment, none of the variables of the medication to evacuation (enemas or suppositories), difficulties to evacuate, digitation to evacuate, returning to the toilet to evacuate, feeling of incomplete evacuation, straining for evacuation, needing time for evacuation, lifestyle alteration, rectal bleeding and total score, no statistically significant difference was observed between the 4 types of dysnergic constipation patients studied (P>0.05). Also, all the scores of the constipation criteria, including the medication to evacuation (enemas or suppositories), difficulties to evacuate, digitation to evacuate, returning to the toilet to evacuate, feeling of incomplete evacuation, straining for evacuation, needing time for evacuation, lifestyle alteration, rectal bleeding and total score after biofeedback treatment were significantly lower than before treatment (P<0.05).