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Prospective assessment of biofeedback for the treatment of paradoxical puborectalis contraction

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Diseases of the Colon & Rectum

Abstract

Eighteen patients with chronic constipation were diagnosed as having paradoxical puborectalis contraction (PPC) as the cause for their constipation. The diagnosis of PPC was made after office evaluation, colonic transit study, manometry, cinedefecography, and electromyography (EMG). These 18 patients had a mean duration of symptoms of 26.9 years; none of these patients had unassisted bowel movements. Fourteen patients had a mean of 4.6 laxative-induced bowel evacuations per week, and 11 patients had a mean of 4.4 enema-induced bowel evacuations per week. Patients underwent a mean of 8.9 one-hour EMG-based biofeedback sessions. At a mean follow-up of 9.1 (range, 0.5–12) months, these 18 patients had a mean of 7.3 unassisted bowel actions per week ( P <0.0001). In addition, persistent laxative use was reported by only two patients, and, in both cases, this was once a week or less ( P <0.001). Similarly, enema use was reported by only three patients, one once weekly and the other two thrice weekly ( P <0.002). No biofeedback-related complications were identified. EMG-based biofeedback is a valuable technique associated with an 89 percent success rate in the treatment of PPC.

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Authors and Affiliations

  1. Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale, Florida

    Steven D. Wexner M.D., John D. Cheape M.D., Jose M. N. Jorge M.D., Steve Heymen B.A. & David G. Jagelman M.D.

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  1. Steven D. Wexner M.D.
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  2. John D. Cheape M.D.
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  3. Jose M. N. Jorge M.D.
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  4. Steve Heymen B.A.
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  5. David G. Jagelman M.D.
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Additional information

Read at the meeting of The American Society of Colon and Rectal Surgeons, Boston, Massachusetts, May 12 to 17, 1991.

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Wexner, S.D., Cheape, J.D., Jorge, J.M.N. et al. Prospective assessment of biofeedback for the treatment of paradoxical puborectalis contraction. Dis Colon Rectum 35, 145–150 (1992). https://doi.org/10.1007/BF02050669

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