Biofeedback treatment of constipation: a comparison of two methods

Abstract

Objectives: Our purpose in this study was to determine whether, with balloon feedback treatment, one can obtain results similar to those achieved with electromyographic (EMG) feedback treatment, in patients with a functional outlet obstruction (spastic pelvic floor syndrome).

Methods: In a randomized controlled study, 11 patients received EMG biofeedback and nine patients received balloon feedback. Treatment outcome was assessed by standard EMG during straining, constipation score, and a standard diary with details about complaints.

Results: Using change scores (posttreatment score minus pretreatment score), we found significantly greater positive changes for EMG feedback at posttreatment and at follow-up. When criteria for good clinical outcome were used, eight of 11 patients treated with EMG feedback appeared to be improved, against two of nine patients treated with balloon feedback. Type of feedback was the only difference between the groups.

Conclusions: Alteration of the EMG pattern leads to lessening of complaints, which means that pelvic floor contraction during straining indeed is the cause of the constipation. The results suggest that EMG feedback is more effective than balloon feedback in treating spastic pelvic floor syndrome.