Biofeedback therapy improves dyssynergic defecation in elderly women
Electromyographic biofeedback (EMG-BF) appears to be an effective behavioural therapy for improving dyssynergic defecation in chronically constipated community-dwelling elderly women, according to a recent study.
There were significant differences between randomized groups in all the dependent variables after 1 month of treatment. In addition, no significant between-group difference was seen in age or in the duration of chronic constipation symptoms.
Clinical gains were maintained over a follow-up of 3 months, according to researchers.
To assess the efficacy of BF therapy in the treatment of dyssynergic defecation, 20 chronically constipated women were randomly assigned to either EMG-BF group (n=10) or control group (n=10) after an initial assessment phase carried out for 1 month.
The outcome measures for evaluating treatment efficacy were as follows: weekly stool frequency, sensation of incomplete evacuation, difficulty evacuation level, Anismus index and mean EMG-activity of the external anal sphincter during straining to defecate.
The findings of the current study supported those of a previous randomized controlled trial by Simon and Bueno. [Appl Psychophysiol Biofeedback 2009;34:273-7]
Their results showed that patients in the EMG-BF group had significant improvements in psychophysiological measures (EMG-activity during straining to defecate and Anismus index), as well as in clinical variables (frequency of defecations per week, sensation of incomplete evacuation, difficulty evacuation level and perianal pain at defecation). These benefits were maintained at the follow-up period 2 months later.
One of the most common forms of functional constipation, dyssynergic defecation refers to an incomplete evacuation of faecal material from the rectum due to paradoxical contraction or failure to relax pelvic floor muscles when straining to defecate. It is said to be a behavioural disorder because there are no associated morphological or neurological abnormalities. [World J Gastroenterol 2006;12:7069-74]