Prospective, randomized trial comparing four biofeedback techniques for patients with constipation

PURPOSE: The aim of this study was to compare four methods of biofeedback f or patients with constipation. METHODS: Thirty-six patients were prospectiv ely, randomly assigned to one of four protocols: 1) outpatient intra-anal e lectromyographic biofeedback training; 2) electromyographic biofeedback tra ining plus intrarectal balloon training; 3) electromyographic biofeedback t raining plus home training; or 4) electromyographic biofeedback training, b alloon training, and home training. All 36 patients received weekly one-hou r outpatient biofeedback training. Success was measured by increased unassi sted bowel movements and reduction in cathartic use. In all instances patie nts maintained a daily log in which documentation was maintained regarding each bowel evacuation and the need for any cathartics. RESULTS; There was a statistically significant increase in unassisted bowel movements for Group s 1, 2, and 4 (P < 0.05) and a reduction in the use of cathartics in Groups 1, 2, and 3 (P ( 0.05). CONCLUSION: There was a significant improvement in outcome after all four treatment protocols for constipation; however, no s ignificant difference was found among the treatments. Therefore, electromyo graphic biofeedback training alone is as effective as with the addition of balloon training, home training, or both.