Responses of anal constipation to biofeedback treatment

Fernandez‐Fraga, X.; Azpiroz, Fernando; Casaus, Maite; Aparici, Anna; Malagelada, Juan–R.

doi:10.1080/00365520410009348

Cited by 22 publications

(24 citation statements)

References 27 publications

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“…However, there were no significant differences between responders and non-responders in the current study and several reports are in agreement with our findings (15, 25). …”

Section: Discussionsupporting

confidence: 94%

“…The results showed that the inability to evacuate an intrarectal balloon on the balloon expulsion test was related to the failure of biofeedback therapy. Several previously published studies using various expulsion tests have also demonstrated that impaired expulsion capacity is related to poor treatment outcomes (24, 25). The reason for these results is unclear; however, because the severity of defecatory dysfunction was evaluated by means of the balloon expulsion test (25), we speculate that severe defecatory dysfunction prior to biofeedback therapy is related to treatment failure.…”

Section: Discussionmentioning

confidence: 95%

“…Several previously published studies using various expulsion tests have also demonstrated that impaired expulsion capacity is related to poor treatment outcomes (24, 25). The reason for these results is unclear; however, because the severity of defecatory dysfunction was evaluated by means of the balloon expulsion test (25), we speculate that severe defecatory dysfunction prior to biofeedback therapy is related to treatment failure. According to Mckee et al (26), biofeedback was not helpful in patients who had deranged pelvic floor physiology.…”

Section: Discussionmentioning

confidence: 95%

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Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

et al. 2010

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The purpose of this study is to evaluate the predictive capability of anorectal physiologic tests for unfavorable outcomes prior to the initiation of biofeedback therapy in patients with dyssynergic defecation. We analyzed a total of 80 consecutive patients who received biofeedback therapy for chronic idiopathic functional constipation with dyssynergic defecation. After classifying the patients into two groups (responders and non-responders), univariate and multivariate analyses were performed to determine the predictors associated with the responsiveness to biofeedback therapy. Of the 80 patients, 63 (78.7%) responded to biofeedback therapy and 17 (21.3%) did not. On univariate analysis, the inability to evacuate an intrarectal balloon (P=0.028), higher rectal volume for first, urgent, and maximal sensation (P=0.023, P=0.008, P=0.007, respectively), and increased anorectal angle during squeeze (P=0.020) were associated with poor outcomes. On multivariate analysis, the inability to evacuate an intrarectal balloon (P=0.018) and increased anorectal angle during squeeze (P=0.029) were both found to be independently associated with a lack of response to biofeedback therapy. Our data show that the two anorectal physiologic test factors are associated with poor response to biofeedback therapy for patients with dyssynergic defecation. These findings may assist physicians in predicting the responsiveness to therapy for this patient population.

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“…However, there were no significant differences between responders and non-responders in the current study and several reports are in agreement with our findings (15, 25). …”

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 95%

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Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

et al. 2010

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“…Physiotherapy or biofeedback is the next step in both patients with or without slow transit or anismus [9,10] . In patients with constipation, RCI is also used to clean the bowel.…”

Section: Introductionmentioning

confidence: 99%

Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

Cazemier¹,

Felt‐Bersma²,

Mulder³

2007

WJG

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AIM:To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation. METHODS:Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire. RESULTS:Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94 % vs 65%, P = 0.05).Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation. CONCLUSION:RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

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“…Therefore, this test should be integrated along with other anorectal physiologic tests. Some studies reported a capability of BET for predicting the outcomes in patients following biofeedback therapy [12][13][14] and further studies are necessary regarding this issue.…”

Section: 11mentioning

confidence: 99%

How to Perform and Interpret Balloon Expulsion Test

Lee

Kim

2014

J Neurogastroenterol Motil

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Responses of anal constipation to biofeedback treatment

Abstract: Even in the presence of negative predictors, biofeedback is a valuable treatment option in a substantial proportion of constipated patients.

Cited by 22 publications

References 27 publications

Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

How to Perform and Interpret Balloon Expulsion Test

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