Comparing Biofeedback Therapy and Balloon Defecation Training in Treatment of Dyssynergic Defecation

Dyssynergic defecation does not respond appropriately to routine treatments of constipation. Re-cently, researches have shown that biofeedback therapy is useful in anorectal dyssynergia. This study compared two treatment modalities for these patients.

Fifty nine subjects with dyssynergic defecation were recruited. They allocated randomly to two groups of balloon defecation training and biofeedback therapy. In the first group, a balloon was inserted into the rectum and inflated with water injection; so that the patient had the sensation of full rectum and thus the need to defecate; then the patient was asked to reject the balloon. In the biofeedback group, the pen electrode of EMG biofeedback was inserted into rectum and the patient tried to increase abdominal pressure and relax rectal muscles accordingly.

The findings of the study showed a reduction in constipation of both groups. The ability to reject bal-loon (volume and time) was significantly better in post-intervention measurements; better results were found in biofeedback arm of the study. Patient satisfaction after treatment reached to 52% by balloon training and 79% in biofeedback group. Report of incomplete evacuation and need for digital use during defecation stayed constant after treatment in balloon trained cases.

Biofeedback seems to be superior to balloon defecation training and did made measurable changes in subjective and objective variables of dyssynergia.