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KMID : 0356719960120020185
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Journal of the Korean Society of Coloproctology
1996 Volume.12 No. 2 p.185 ~ p.192
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Effect of Biofeedback Trainining in Anismus
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You Kwang-Hyun
Nah Young-Ho
Jin Kyung-Min
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Abstract
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Objectives: Biofeedback training are known to be useful in the treatment of patients with anismus. Several studies suggest that biofeedback training may have a therapeutic values. But there are no reports in Korea on biofeedback treatment in patients with anismus. This study was carried out to evaluate therapeutic efficacy of biofeedback training in anismus.
Methods: Twenty-six subjects with intractable constipation due to anismus, over 1 yr-duration, were included in this study. The diagnosis of anismus was made by office evaluation, colonic transit study, manometry, and defecography. These 26 patients were divided into two groups, 13 patients with laxative for sixth months(drug therapy group)
and other 13 patients with biofeedback training(biofeedback group). The training was consisted of sessions of 2hr duration, 2 times per week for 3 months. At nine month, subjective symptoms and objective parameters were compared between the two groups.
Results: 3 of 13 patients in biofeedback group and 11 of 13 patients in drug theraphy group experienced symptom recurrence. Anorectal angle was 116。 at straining and 118 。 at rest before biofeedback. It increased to 138。 at straining after biofeedback, but it did not change in drug theraphy group. Anal high pressure cone was relaxed in 12 of
13 patients in biofeedback group and 2 of 13 patients in drug theraphy group after treatment. Balloon expulsion was successful in 12 of 13 patients in biofeedback group and 3 of 13 patients in drug theraphy group(P<0.05). Degree of anal relaxation(%) was 11(±20) before treatment and 80(±20) after treatment in biofeedback group, but it was 10(±18) before treatment and 20(±23) after treatment in drug theraphy group(P<0.05). Defecation index(rectal pressure on bearing down/anal residual pressure) increased from 0.7(±0.3) before treatment to 3.7(±2.2) after biofeedback treatment, while it was not changed in drug therapy group(P<0.05). But rectal pressure on straining were not different in both group.
Conclusion: Biofeedback training is safe, inexpensive, and easilly mastered methods. It is helpful in the treatment of patients with anismus. But it is labor intensive, requires an enthusiastic trainer and an absolute cooperation from the patients.
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KEYWORD
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Anismus, Biofeedback
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