Published online Jul 21, 2014. doi: 10.3748/wjg.v20.i27.9162
Revised: February 26, 2014
Accepted: April 15, 2014
Published online: July 21, 2014
AIM: To compare biofeedback-guided pelvic floor exercise therapy (BFT) with the use of oral polyethylene glycol (PEG) for the treatment of obstructive defecation.
METHODS: A total of 88 subjects were assigned to treatment with either BFT (n = 44) or oral PEG (n = 44). Constipation symptoms (including difficult evacuation, hard stool, digitation necessity, incomplete emptying sensation, laxative dependence, perianal pain at defecation, and constipation satisfaction), Wexner Scores, and quality of life scores were assessed after 1, 3, and 6 mo.
RESULTS: At the 6 mo follow-up, the symptoms of the BFT group patients showed significantly greater improvements compared with the PEG group regarding difficult evacuation, hard stools, digitation necessity, laxative dependence, perianal pain at defecation, constipation satisfaction, Wexner Constipation Score, and quality of life score (P < 0.05). The quality of life score of the BFT group at the final follow-up time (6 mo) was 80 ± 2.2. After a complete course of training, improvements in the clinical symptoms of the BFT group were markedly improved (P < 0.05), and the Wexner Constipation Scores were greatly decreased compared with the oral PEG group (P < 0.05).
CONCLUSION: We concluded that manometric biofeedback-guided pelvic floor exercise training is superior to oral polyethylene glycol therapy for obstructive defecation.
Core tip: Until now, there have been no standard treatment methods for obstructed defecation. Although we believe biofeedback is more beneficial for obstructive defecation, recent controlled studies indicate that the efficacy of manometric biofeedback treatment for obstructive defecation remains controversial. The main purpose of this research was to assess and compare the quality of life scores of patients diagnosed with obstructive defecation following treatment with biofeedback therapy or oral polyethylene glycol management. Biofeedback had the clear effect of teaching patients how to squeeze and relax their anorectal and pelvic floor muscles during defecation. The data in this study show a clear superiority of biofeedback related to oral polyethylene glycol for the treatment of this subtype of constipation. If this research was extended to large multicenter randomized trials and its efficiency proven, biofeedback could become the standard treatment method for obstructive defecation.