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Abdominal Symptoms Are Common and Benefit from Biofeedback Therapy in Patients with Dyssynergic Defecation.

Baker J, Eswaran S, Saad R, Menees S, Shifferd J, Erickson K, Barthelemy A, Chey WD - Clin Transl Gastroenterol (2015)

Bottom Line: Abdominal, anorectal, and stool symptoms are commonly reported by DD patients, but limited data exist to demonstrate the improvement of these associated symptoms to BFT.The proportion of patients with at least moderate symptoms decreased in all 12 questionnaire items, including all abdominal symptoms, after completing BFT (46.8% to 14.3%, P<0.001).Limitations of this study are observational design, lack of control group, and lack of long-term follow-up.

View Article: PubMed Central - PubMed

Affiliation: 1] Michigan Bowel Control Program, University of Michigan Health System, Ann Arbor, Michigan, USA [2] Gastrointestinal Physiology Laboratory Coordinator, University of Michigan, Ann Arbor, Michigan, USA.

ABSTRACT

Objectives: Dyssynergic defecation (DD) is a subtype of chronic constipation that responds to biofeedback therapy (BFT). Abdominal, anorectal, and stool symptoms are commonly reported by DD patients, but limited data exist to demonstrate the improvement of these associated symptoms to BFT. Aims to prospectively study the response of constipation and associated abdominal, rectal, and stool symptoms to biofeedback in a population with dyssynergia.

Methods: Patients with DD as determined by anorectal manometry and balloon expulsion testing were included into the study. All patients completed a validated survey, the Personal Assessment of Constipation Symptom (PAC-SYM) questionnaire, before and following BFT. The PAC-SYM is a clinical tool to assess constipation-related symptom frequency and severity.

Results: Seventy-seven dyssynergic patients fulfilled the study requirements. Abdominal symptoms were present in up to 74% of patients with dyssynergia. PAC-SYM summation scores improved following completion of biofeedback by 48%, from 22.08 to 11.48 (P<0.001). The proportion of patients with at least moderate symptoms decreased in all 12 questionnaire items, including all abdominal symptoms, after completing BFT (46.8% to 14.3%, P<0.001).

Conclusions: Abdominal symptoms are common in patients with dyssynergia. BFT improves both anorectal-related constipation symptoms and associated abdominal symptoms in patients with DD. Limitations of this study are observational design, lack of control group, and lack of long-term follow-up.

No MeSH data available.


Related in: MedlinePlus

Flowchart for participant inclusion. Anorectal manometry (ARM), chronic constipation (CC), balloon expulsion test (BET).
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fig1: Flowchart for participant inclusion. Anorectal manometry (ARM), chronic constipation (CC), balloon expulsion test (BET).

Mentions: One hundred eighty-nine patients were evaluated for inclusion into the study (Figure 1). Seventy-seven patients met inclusion criteria and successfully completed BFT. One hundred twelve patients were not included in the analysis either because they did not meet inclusion criteria for dyssynergia or because they did not initiate BFT. Patients cited multiple reasons regarding failure to complete BFT: lack of insurance coverage for this service, travel distance, and interference of other medical problems. The average age was 51 years old (median=52 years, range=18–88 years). In all, 64% of patients were female and 88% were Caucasian. The multiple linear regression model including age, gender, and race depicted no significant association for BFT improvement.


Abdominal Symptoms Are Common and Benefit from Biofeedback Therapy in Patients with Dyssynergic Defecation.

Baker J, Eswaran S, Saad R, Menees S, Shifferd J, Erickson K, Barthelemy A, Chey WD - Clin Transl Gastroenterol (2015)

Flowchart for participant inclusion. Anorectal manometry (ARM), chronic constipation (CC), balloon expulsion test (BET).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4816253&req=5

fig1: Flowchart for participant inclusion. Anorectal manometry (ARM), chronic constipation (CC), balloon expulsion test (BET).
Mentions: One hundred eighty-nine patients were evaluated for inclusion into the study (Figure 1). Seventy-seven patients met inclusion criteria and successfully completed BFT. One hundred twelve patients were not included in the analysis either because they did not meet inclusion criteria for dyssynergia or because they did not initiate BFT. Patients cited multiple reasons regarding failure to complete BFT: lack of insurance coverage for this service, travel distance, and interference of other medical problems. The average age was 51 years old (median=52 years, range=18–88 years). In all, 64% of patients were female and 88% were Caucasian. The multiple linear regression model including age, gender, and race depicted no significant association for BFT improvement.

Bottom Line: Abdominal, anorectal, and stool symptoms are commonly reported by DD patients, but limited data exist to demonstrate the improvement of these associated symptoms to BFT.The proportion of patients with at least moderate symptoms decreased in all 12 questionnaire items, including all abdominal symptoms, after completing BFT (46.8% to 14.3%, P<0.001).Limitations of this study are observational design, lack of control group, and lack of long-term follow-up.

View Article: PubMed Central - PubMed

Affiliation: 1] Michigan Bowel Control Program, University of Michigan Health System, Ann Arbor, Michigan, USA [2] Gastrointestinal Physiology Laboratory Coordinator, University of Michigan, Ann Arbor, Michigan, USA.

ABSTRACT

Objectives: Dyssynergic defecation (DD) is a subtype of chronic constipation that responds to biofeedback therapy (BFT). Abdominal, anorectal, and stool symptoms are commonly reported by DD patients, but limited data exist to demonstrate the improvement of these associated symptoms to BFT. Aims to prospectively study the response of constipation and associated abdominal, rectal, and stool symptoms to biofeedback in a population with dyssynergia.

Methods: Patients with DD as determined by anorectal manometry and balloon expulsion testing were included into the study. All patients completed a validated survey, the Personal Assessment of Constipation Symptom (PAC-SYM) questionnaire, before and following BFT. The PAC-SYM is a clinical tool to assess constipation-related symptom frequency and severity.

Results: Seventy-seven dyssynergic patients fulfilled the study requirements. Abdominal symptoms were present in up to 74% of patients with dyssynergia. PAC-SYM summation scores improved following completion of biofeedback by 48%, from 22.08 to 11.48 (P<0.001). The proportion of patients with at least moderate symptoms decreased in all 12 questionnaire items, including all abdominal symptoms, after completing BFT (46.8% to 14.3%, P<0.001).

Conclusions: Abdominal symptoms are common in patients with dyssynergia. BFT improves both anorectal-related constipation symptoms and associated abdominal symptoms in patients with DD. Limitations of this study are observational design, lack of control group, and lack of long-term follow-up.

No MeSH data available.


Related in: MedlinePlus