DDW: Anorectal Biofeedback Benefits Some IBS Patients

WASHINGTON, May 25 -- A common treatment for constipation may also be effective in patients with irritable bowel syndrome (IBS) who have constipation-like symptoms caused by pelvic floor dyssynergia, researchers said here.

After three months of weekly anorectal biofeedback therapy, women with the condition experienced significant improvement in bowel satisfaction, bowel function, and quality of life, reported Vid Suttor, M.D., of the Royal North Shore Hospital in Sydney, Australia, at the Digestive Disease Week meetings.

Pelvic floor dyssynergia is a condition in which the muscles and ligaments at the base of the abdomen that support the uterus, bladder, urethra, and rectum-the pelvic floor-don't work in a coordinated fashion, Dr. Suttor said. Significant numbers of patients with IBS also suffer from this condition.

It causes many of the symptoms of constipation, including straining, a sense of incomplete evacuation, sensation of a blocked anus, and pain, Dr. Suttor said. There is no satisfactory treatment, and patients' quality of life is seriously affected, she added.

Dr. Suttor and colleagues enrolled 25 women with IBS and pelvic floor dyssynergia to undergo weekly sessions of biofeedback therapy. During the sessions, a gastroenterologist and a nurse worked together to train patients in how to use their abdominal muscles and how to breathe properly in order to help have a bowel movement. A biofeedback monitor allowed patients to see and react to their rectal pressure.

The therapy also included simulated defection with a water-filled balloon.

The researchers also enrolled 25 women with constipation. They underwent the same biofeedback sessions, so the researchers could directly compare the effectiveness of biofeedback therapy for the two conditions.

Global bowel satisfaction, as measured by a 10-cm visual analog scale, improved by about 5 cm in both groups (P