Biofeedback treatment of chronic constipation: myths and misconceptions

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• 作者：G. Chiarioni
• 关键词：Biofeedback ; Constipation ; Obstructed defecation ; Dyssynergic defecation
• 刊名：Techniques in Coloproctology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：20
• 期：9
• 页码：611-618
• 全文大小：403 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Gastroenterology
  Proctology
  Abdominal Surgery
  Colorectal Surgery
  
• 出版者：Springer Milan
• ISSN：1128-045X
• 卷排序：20

文摘

Chronic constipation is a prevalent disorder with considerable impact on healthcare costs and quality of life. Most patients would respond to conservative measures in primary care. Patients with refractory constipation are commonly referred to dedicated centers for appropriate investigations and management. After testing, three main subtypes of constipation are commonly identified: normal colon transit, slow transit, and functional defecation disorders. The etiology of functional defecation disorders is consistent with maladaptive behavior, and biofeedback therapy has been considered a valuable treatment option. Being safe and only marginally invasive, retraining has been historically employed to manage all types of refractory constipation. There are a number of strongly held beliefs about biofeedback therapy that are not evidence-based. The aim of this review was to address these beliefs concerning protocols, efficacy, indications, and safety, with a special focus on the relevance of identifying patients with a functional defecation disorder who are ideal candidates for retraining. Randomized controlled trials support the effectiveness of biofeedback therapy for severe, refractory constipation due to functional defecation disorders. Limitations of the treatment are discussed, but biofeedback remains the safest option to successfully manage this hard-to-treat subtype of constipation.