J Korean Soc Coloproctol.  2006 Jun;22(3):162-168.

Are There Anorectal Physiologic Factors Prior to Biofeedback Treatment for Constipation that Affect Compliance Rate?

• Shin DH
• Kim SC
• Kim IK
• Hong HK
• Joo JS

Abstract

PURPOSE
The most important factor for the success of biofeedback treatment of constipation is patients' enthusiastic participation and willingness to comply with the treatment protocol. The purpose of this study was to analyze differences among groups of patients classified according to the number of biofeedback sessions and to identify any anorectal physiological and clinical factors related with better compliance with biofeedback treatment.
METHODS
From Aug. 2001 to July 2003, 80 patients who had undergone biofeedback treatment for constipation by a single therapist were classified into three groups according to the number of sessions: only one session (Group I, n=26), two or three sessions (Group II, n=27), and more than four sessions (Group III, n=27). We reviewed the clinical and the anorectal physiological characteristics retrospectively.
RESULTS
The mean age was 39.1 (range, 8~77) years, and the mean duration of constipation was 7.7 (range, 0.5~30) years and mean frequency of defecation was 2.2 times/week. Patients' pretreatment use of laxatives was significantly lower in Group I (38.5 percent) than in Group II (70.4 percent) or Group III (51.9 percent) (P<0.05). There were no significant differences in anal manometric parameters (mean and maximal resting pressure, maximal squeezing pressure, sensitivity, and rectal capacity). In the cinedefecographic findings, the megarectum was significantly higher in Group III (58.3 percent) than in Group I (38.9 percent) or Group II (27.8 percent) (P=0.02), but other findings of anismus, rectocele, intussusception, and delayed emptying showed no significant differences. The cinedefecographic parameters (anorectal angle, perineal descent, anal canal length, and puborectalis length), were not significantiy different among the groups.
CONCLUSIONS
We strongly recommend biofeedback treatment for constipation patients who abuse laxatives and/or for whom cinedefecography reveals megarectum.

Keyword

Biofeedback treatment; Compliance; Laxatives; Megarectum

MeSH Terms

Anal Canal
Biofeedback, Psychology*
Clinical Protocols
Compliance*
Constipation*
Defecation
Humans
Intussusception
Laxatives
Rectocele
Retrospective Studies
Laxatives