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The role of biofeedback in the treatment of gastrointestinal disorders

Authors :
William E. Whitehead
Giuseppe Chiarioni
Source :
Nature Clinical Practice Gastroenterology & Hepatology. 5:371-382
Publication Year :
2008
Publisher :
Springer Science and Business Media LLC, 2008.

Abstract

Biofeedback is a form of treatment that has no adverse effects and can be provided by physician extenders. The therapy relies on patients' ability to learn how to influence their bodily functions through dedicated machinery and teaching. This Review provides a comprehensive overview of all potential therapeutic applications of biofeedback for functional constipation, fecal incontinence, functional anorectal pain, IBS, functional dyspepsia, and aerophagia. Practical clinical applications of biofeedback therapy supported by randomized, controlled trials (RCTs) are limited to fecal incontinence and dyssynergic defecation. For fecal incontinence, RCTs suggest that biofeedback combining strength training and sensory discrimination training is effective in approximately 75% of patients and is more effective than placebo. However, verbal feedback provided by a therapist during extended digital examination may be equally effective, and children whose fecal incontinence is associated with constipation plus fecal impaction do no better with biofeedback than medical management. For dyssynergic defecation, RCTs show that biofeedback combining pelvic floor muscle relaxation training, practice in defecating a water-filled balloon, and instruction in effective straining is effective in approximately 70% of patients who have failed to respond to laxative treatment. For both incontinence and dyssynergic defecation, the benefits of biofeedback last at least 12 months.

Details

ISSN :
17434386 and 17434378
Volume :
5
Database :
OpenAIRE
Journal :
Nature Clinical Practice Gastroenterology & Hepatology
Accession number :
edsair.doi.dedup.....0d0b4f5e1f4fe28a04782625528d8fab
Full Text :
https://doi.org/10.1038/ncpgasthep1150