J Korean Med Sci.  2010 Jul;25(7):1060-1065. 10.3346/jkms.2010.25.7.1060.

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

• Shin JK
• Cheon JH
• Kim ES
• Yoon JY
• Lee JH
• Jeon SM
• Bok HJ
• Park JJ
• Moon CM
• Hong SP
• Lee YC
• Kim WH

• KMID: 1792957
• DOI: http://doi.org/10.3346/jkms.2010.25.7.1060

Abstract

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.

Keyword

Biofeedback, Psychology; Dyssynergic Defecation; Predicting Factors; Balloon Expulsion Test; Anorectal Manometry; Defecogram

MeSH Terms

Adult
Aged
Anal Canal/*physiopathology
Ataxia/*physiopathology/therapy
*Biofeedback, Psychology
*Constipation/physiopathology/therapy
Defecation/*physiology
Defecography/methods
Female
Humans
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Rectum/*physiopathology
Treatment Outcome

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