The Effect Of Biofeedback Therapy On Functional Defecation Disorders And Its Subtypes

Objective: To investigate the effect of biofeedback(BF)on functional defecation disorders(FDD)in different subtypes,clinical symptoms,psychologic and other related indicators,and to analyze the trend of BF treatment in different subtypes of FDD.Methods: 56 FDD patients were divided into two subtypes: dyssynergic defecation(ID)and inadequate defecatory propulsion(IDP).Before treatment,the patients' anxiety and depression,constipation symptom score and constipation quality of life score were evaluated.The patients in the two groups received a course of treatment(10 times)biofeedback respectively.During the treatment period,the family training of 2-3 times / week and 20 minutes / time was carried out.The changes of rectal motility and perception,clinical symptoms,Hamilton Anxiety and Depression Scale(HAMA / HAMD)and the Chinese version of the patient assessment of constipation quality of life questionaire(PAC QOL)were compared before and after biofeedback treatment.Evaluate the efficacy of the two groups at the end of treatment,3 months,and 6 months.Results: 1.The anal residual pressure and anal resting pressure(MARP)of the two groups were lower than before treatment,and the difference between the two groups was statistically significant(P < 0.05).The maximum anal sphincter systolic pressure(masp)of the two groups was lower than that before treatment,but there was no significant difference between the two groups(P > 0.05).The defecation pressure of IDP group after treatment was higher than that before treatment,and there was significant difference(P < 0.05).The initial sensory threshold,initial defecation threshold and rectal maximum tolerance of the two groups were lower than those before treatment,but there was no significant difference between the two groups.2.The scores of anxiety and depression,constipation symptom and constipation quality of life in the two groups were significantly lower than those before treatment,and the difference between the two groups was statistically significant(P < 0.05).3.The score of constipation symptoms was positively correlated with HAMA score and HAMD score(r > 0,P < 0.05).4.The total effective rate was 82.14% after the treatment,71.87% after one month,71.87% after three months.The effective rate of ID group was higher than that of IDP group(P > 0.05).The effective rate of ID group at 1 and 3 months was higher than that of IDP group(P < 0.05).The effect of ID group was stable at the end of treatment,1 month and 3 months.The effect of IDP group at 1 month was lower than that at the end of the treatment(P > 0.05).There was no difference between IDP group at 1 and 3 months.Conclusion: 1.Biofeedback can improve rectal motility,but it can not improve rectal perception.2.Biofeedback therapy can improve the clinical symptoms,mental and psychological status of patients,and improve the quality of life of patients with constipation.3.The anxiety and depression of constipation patients with dysdefecation were positively correlated with their constipation symptoms.4.Biofeedback is effective for both FDD subtypes and the short-term efficacy is stable.The effect on the ID group was better than that on the IDP group.