Study findings indicate that biofeedback is far more effective than laxatives in relieving constipation caused by inappropriate contraction or inability to relax the pelvic floor muscles during defecation — what doctors call “pelvic floor dyssynergia.”
“Biofeedback should become the treatment of choice for this common and easily diagnosed type of constipation,” the investigators conclude.
In a randomized, controlled trial, Dr. Giuseppe Chiarioni from the University of Verona in Italy and an international team compared the effects of five weekly 30-minute biofeedback sessions with one of the most effective laxatives (polyethylene glycol) plus constipation prevention counseling.
Biofeedback training included teaching subjects to strain more effectively, to coordinate expulsion efforts with their breathing and to relax pelvic floor muscles.
Compared with laxatives, biofeedback produced greater reductions in straining, sensations of incomplete evacuation, and blockage, use of enemas and suppositories and abnormal pain, according to a report of the study in Gastroenterology. Stool frequency increased in both treatment arms.
Pelvic floor dyssynergia is one of the most disabling subtypes of constipation. “Our findings should prompt physicians to search for this common subtype of functional constipation to avoid treating affected patients with a poorly effective therapy (laxatives),” Dr. Chiarioni told.