Biofeedback is equally effective in patients with short or long duration of functional constipation

Abstract

Background: We have previously showed that biofeedback was effective in patients with functional constipation. Aim: to investigate if biofeedback is more effective in patients with short or long duration of functional constipation. Methods: Patients with functional constipation satisfying the Rome II criteria were recruited. Short duration of constipation was defined arbitrarily as ≤5 years, and long duration as >5 years. Patients were asked to stop all laxative medication for two weeks and record daily bowel habits on a diary card, as well as complete a constipation symptom severity questionnaire. Use of rescue laxatives was recorded. Biofeedback consisted of teaching of proper defecation posture, abdominal muscle exercise, pelvic floor retraining with pressure and biofeedback and also training of balloon expulsion from the rectum. Each session lasted 30-60 minutes and was repeated weekly for six sessions. Bowel symptoms, defecation frequency were assessed at baseline and after six weeks. Severity of bowel symptoms were assessed in a 5 point Likert scale. Changes in symptom severity from baseline were compared in the long and short duration groups using Mann-Whitney U test. Results: There were 16 patients with short duration and 39 with long duration. The two groups did not differ in age (44 ± 14 vs 49 ± 12 years, p=0.16) or sex (female: 75% vs 89.7%, p=0.15). After completion of treatment, the number of complete spontaneous bowel movements increased similarly in both groups (3.0 vs 2.5, p=0.32), and constipation symptoms decrease in both groups: bloating (-1.1 vs -0.89, p= 0.43), incomplete evacuation (-1.7 vs -1.7, p=0.65), straining (-1.0 vs -1.0, p=0.99) and laxative use (-3.2 vs -5.0, p=0.45). Conclusion: Biofeedback is equally effective in those with long and short duration constipation.