جستجوی مقالات مرتبط با کلیدواژه « اختلال ناهماهنگی مقعدی » در نشریات گروه « پزشکی »

Researches has shown that doing the appropriate defecation exercise with biofeedback is the treatment for dyssynergic defecation, but since in many researches it has been indicated that every treatment such as medication, physical therapy & even surgery has a kind of placebo effect on patients; therefore, in this study we made a comparison on the effectiveness of therapies between biofeedback and placebo feedback by measuring recovery level of patients suffering from dyssynergic defecation. In this study we implemented clinical trial method in such a way that from totally 42 patients complaining of constipation, 30 patients were selected on the basis of ROMEIII inclusion criteria and were randomly placed in two groups to receive biofeedback & placebo feedback therapies, so that we could measure and compare the ability to defecate the balloon (volume & time) before and after the treatment. The signs of dyssynergic defecation were improved in both groups in comparison to their pre-therapy time and an advantage was observed in quantitative variables among the patients who received biofeedback therapy. There were significant and positive changes in the criteria of: defecate balloon time& volume in biofeedback group (p<0/05).In qualitative variables such as: hard stool, pain, excessive strain during bowel movement and feeling of incomplete evacuation, changes weresignificant(p<0/05). But there was no significant changes in bleeding, numbers of bowel movement during a week & digital evacuation (p>0/05). The signs of improvement concerning fecal impaction weresignificantjust in placebo feedback group (p<0/05). Biofeedback therapy among patients with dyssynergic defecation has placebo effect.

Dyssynergic defecation does not respond appropriately to routine treatments of constipation. Re-cently, researches have shown that biofeedback therapy is useful in anorectal dyssynergia. This study compared two treatment modalities for these patients.

Fifty nine subjects with dyssynergic defecation were recruited. They allocated randomly to two groups of balloon defecation training and biofeedback therapy. In the first group, a balloon was inserted into the rectum and inflated with water injection; so that the patient had the sensation of full rectum and thus the need to defecate; then the patient was asked to reject the balloon. In the biofeedback group, the pen electrode of EMG biofeedback was inserted into rectum and the patient tried to increase abdominal pressure and relax rectal muscles accordingly.

The findings of the study showed a reduction in constipation of both groups. The ability to reject bal-loon (volume and time) was significantly better in post-intervention measurements; better results were found in biofeedback arm of the study. Patient satisfaction after treatment reached to 52% by balloon training and 79% in biofeedback group. Report of incomplete evacuation and need for digital use during defecation stayed constant after treatment in balloon trained cases.

Biofeedback seems to be superior to balloon defecation training and did made measurable changes in subjective and objective variables of dyssynergia.