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The Effect of Biofeedback Therapy on Dyssynergic Constipation in Patients With or Without Irritable Bowel Syndrome



Ahadi T1 ; Madjlesi F1 ; Mahjoubi B2 ; Mirzaei R2 ; Forogh B1 ; Daliri SS1 ; Derakhshandeh SM3 ; Behbahani RB1 ; Raissi GR1
Authors
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Authors Affiliations
  1. 1. Department of Physical Medicine and Rehabilitation, Iran University of Medical Science, Tehran, Iran
  2. 2. Department of Surgery, Iran University of Medical Science, Tehran, Iran
  3. 3. Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Research in Medical Sciences Published:2014

Abstract

Background: The Rome II and III diagnostic criteria for dyssynergic defecation recommended the exclusion of irritable bowel syndrome (IBS). This study determined the effect of biofeedback therapy on dyssynergic constipation in patients with or without IBS.; Materials and Methods: This study was a nonrandomized, single blinded, semi experimental study. Dyssynergic defecation patients with and without IBS were asked to undergo biofeedback therapy 8 sessions. The defecation dynamics and balloon expulsion time were evaluated before, at the end and 1 month after the biofeedback therapy. IBS symptoms were graded using a 4-point Likert scale. Mann–Whitney U-test, Wilcoxon test and Friedman test were applied to analyze data using SPSS software package (SPSS Inc., Chicago, IL, USA).; Results: After the biofeedback therapy, the IBS symptoms have been decreased significantly (the median of 2 before and 1 after therapy, P < 0.01). The biofeedback therapy significantly decreased the anismus index in IBS group by the mean of 0.75 ± 0.31, 0.28 ± 0.07 and 0.28 ± 0.06 in three phases, respectively. Similar results were found in non-IBS patients (the mean of 0.74 ± 0.32, 0.28 ± 0.08, 0.27 ± 0.08 in three phases, respectively). The symptoms of constipation (sensation of incomplete evacuation, difficult and painful defecation), defecation facilitative manual maneuver frequency, pelvic floor muscles resting amplitude and strain amplitude decreased and squeezing amplitude improved significantly after biofeedback therapy in both groups with and without IBS (P < 0.001). There were not significant differences between patients with and without IBS (P > 0.05) with respect to outcome. No complication was observed in treatment groups.; Conclusion: Dyssynergic constipation patients with and without IBS will likely benefit from biofeedback therapy. © 2014, Isfahan University of Medical Sciences(IUMS). All rights reserved.
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