Biofeedback for Constipation

man undergoing biofeedback
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Since biofeedback has been used to treat a wide variety of physical disorders, it seems natural to wonder if biofeedback is effective as a treatment for chronic constipation.

Biofeedback involves placing sensors on specific parts of your body in order to give you feedback as to how they are functioning. Depending on the treatment target, biofeedback measures such things as heart rate, muscle tension and sweat activity.

You can then use these measurements to bring about desired changes.

Wanting to learn more about biofeedback as a treatment for constipation, I turned to UpToDate -- an electronic reference used by many physicians and patients looking for in-depth medical information. Here is what I found:

"Biofeedback is a behavioral approach that can be used by some people with severe chronic constipation. During defecation, the muscles of the pelvic floor and external anal sphincter should relax as a person bears down. Biofeedback can be helpful in treating people who involuntarily squeeze (rather than relax) these muscles (referred to as dyssynergic defecation).

"A visual monitor is used to measure external anal sphincter pressures while bearing down. The patient watches the recordings of muscle activity and is asked to change their responses through trial and error."

This excerpt suggests that biofeedback may be a viable treatment option for you if your chronic constipation is severe and you appear to suffer from dyssynergic defecation.

Dyssynergic defecation is a condition involving the nerves and muscles in your pelvic floor - the part of your body that supports the organs in your lower abdomen. When a person suffers from dyssynergic defecation, the muscles in the pelvic floor and the anus do not relax as they should during a bowel movement.

Biofeedback for dyssynergic defecation involves retraining your pelvic floor muscles. Although painless, the procedure is certainly awkward. Small sensors are inserted within the anus, while other sensors may be placed within your vagina (if female) or on your abdomen. You will be asked to bear down as if you are having a bowel movement. As you do so, you will see a graphic display of your muscle tension on a display screen. This feedback will allow you to change the way your muscles respond, so that you learn to consciously relax the muscles in this area when you wish to initiate a bowel movement. 

The American College of Gastroenterology, in its 2014 research review, conclude that biofeedback can be helpful for people for whom pelvic floor dysfunction has been diagnosed in contributing to chronic constipation. The ACG reviewers note that it is difficult for patients to find experienced practitioners. In real-life, many patients are highly resistant to the idea of this treatment, although there is some limited research that patients who actually undergo biofeedback for constipation are happy with the results.

Want to learn more? See UpToDate's topic, "Patient information: Constipation in adults" for additional in-depth, current and unbiased medical information on constipation, including expert physician recommendations.

Sources:

Ford, A., et.al. "American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation" American Journal of Gastroenterology 2014 109:S2-S26.

Heymen, S., et.al. "Biofeedback Treatment of Constipation: A Critical Review" Diseases of the Colon & Rectum 2003 46:1208-1217.

Wiesel, P., et.al. "Patient satisfaction after biofeedback for constipation and pelvic floor dyssynergia." Swiss Medical Weekly 2001 24:152-156.

Wald, A. "Patient information: Constipation in adults" UpToDate. Accessed: October 2009.

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