engleski

Efficiency of biofeedback therapy for chronic constipation in children

Background. Chronic constipation is a common disorder in childhood. The underlying mechanisms responsible for chronic constipation remain unknown. Anorectal manometry shows impaired rectal sensation, inability to defecate balloons, and abnormal defecation dynamics in constipated patients. Conventional methods of treatment often fail to produce satisfactory results. Favorable effects of biofeedback treatment for constipation have been suggested, however, with variable results reported in the literature. Aim. The main aim of the study was to evaluate biofeedback versus conventional therapeutic protocol in the treatment of chronic constipation over a short period of time (3 months), and to follow up therapeutic effects on defecation dynamics and other anorectal manometric parameters. Patients and methods. Forty-nine children with chronic idiopathic constipation, 24 allocated to conventional and 25 to biofeedback therapy, were included in the study. Thorough history data on bowel function and symptoms, anorectal status and manometric testing were collected before and after treatment. Follow up consisted of a structured interview. Results. Mean age was 94 and 92 months in the children treated by the conventional and biofeedback method, respectively. Before treatment, there was no statistically significant between-group difference according to age, duration of constipation, bowel function and other basic characteristics, anorectal physical findings, and manometric parameters. The initial prevalence of abnormal defecation dynamics was 58% and 56% in the group children allocated to conventional and biofeedback therapy, respectively. The difference was not statistically significant. After the treatment, the values of rectal sensation threshold, critical volume, and rectoanal inhibitory reflex volume were significantly higher, and the prevalence of abnormal defecation dynamics was significantly lower in the group on biofeedback therapy. Conclusion. Biofeedback is an effective method of treatment for chronic constipation in children in short term. Therapeutic results are especially favorable in the recovery of abnormal anorectal dynamics and manometric parameters. There is no clear evidence for longterm benefits of biofeedback therapy.

chronic constipation; children; biofeedback therapy

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