H J Lee1,2, S-J Boo3, K W Jung1, S Han4, S Y Seo1, H S Koo1, I J Yoon1, S H Park1, D-H Yang1, K-J Kim1, B D Ye1, J-S Byeon1, S-K Yang1, J-H Kim1, S-J Myung1. 1. Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea. 4. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
BACKGROUND: The beneficial effect of biofeedback therapy (BFT) over a period of more than 2 years has not been studied in a large group of patients. The aim of this study was to evaluate the long-term efficacy of BFT for dyssynergic defecation (DD). METHODS: We evaluated the results for 347 consecutive constipated patients with DD who underwent BFT for a median of five sessions between 2004 and 2009. Initial responses were assessed immediately after the completion of BFT. A responder was defined as a subject with at least a three-point improvement from before to after BFT on an 11-point global bowel satisfaction (GBS) scale, or a two-point improvement if the baseline GBS was more than six points. The probability of remaining a responder was estimated by non-parametric maximum likelihood estimation. KEY RESULTS: The initial response rate to BFT was 72.3% (n = 251), Parkinson's disease and higher baseline GBS scores were associated with initial non-response. The long-term efficacy of BFT was analyzed in 103 patients who were followed up for more than 6 months; the initial effects of BFT were maintained in 85 of the patients (82.5%) during a median of 44 months of follow-up (IQR = 12-68). The probability of remaining a responder was 60% at 2 years, and 58% at 5 years. CONCLUSIONS & INFERENCES: The efficacy of BFT is maintained for more than 2 years after BFT in a considerable proportion of constipated patients with DD. BFT is effective and durable treatment for managing DD.
BACKGROUND: The beneficial effect of biofeedback therapy (BFT) over a period of more than 2 years has not been studied in a large group of patients. The aim of this study was to evaluate the long-term efficacy of BFT for dyssynergic defecation (DD). METHODS: We evaluated the results for 347 consecutive constipatedpatients with DD who underwent BFT for a median of five sessions between 2004 and 2009. Initial responses were assessed immediately after the completion of BFT. A responder was defined as a subject with at least a three-point improvement from before to after BFT on an 11-point global bowel satisfaction (GBS) scale, or a two-point improvement if the baseline GBS was more than six points. The probability of remaining a responder was estimated by non-parametric maximum likelihood estimation. KEY RESULTS: The initial response rate to BFT was 72.3% (n = 251), Parkinson's disease and higher baseline GBS scores were associated with initial non-response. The long-term efficacy of BFT was analyzed in 103 patients who were followed up for more than 6 months; the initial effects of BFT were maintained in 85 of the patients (82.5%) during a median of 44 months of follow-up (IQR = 12-68). The probability of remaining a responder was 60% at 2 years, and 58% at 5 years. CONCLUSIONS & INFERENCES: The efficacy of BFT is maintained for more than 2 years after BFT in a considerable proportion of constipatedpatients with DD. BFT is effective and durable treatment for managing DD.
Authors: Amol Sharma; Satish S C Rao; Kimberly Kearns; Kimberly D Orleck; Scott A Waldman Journal: Aliment Pharmacol Ther Date: 2021-04-28 Impact factor: 8.171
Authors: Miguel A Simón; Ana M Bueno; Patricia Otero; Fernando L Vázquez; Vanessa Blanco Journal: Int J Environ Res Public Health Date: 2019-09-04 Impact factor: 3.390
Authors: Daniëlle A van Reijn-Baggen; Henk W Elzevier; H Putter; Rob C M Pelger; Ingrid J M Han-Geurts Journal: Tech Coloproctol Date: 2022-05-05 Impact factor: 3.699