title: Prospective, randomized trial comparing four biofeedback techniques for patients with constipation.
abstract: OBJECTIVE
  The aim of this study was to compare four methods of biofeedback for patients with constipation.
  
  
  METHODS
  Thirty-six patients were prospectively, randomly assigned to one of four protocols: 1) outpatient intra-anal electromyographic biofeedback training; 2) electromyographic biofeedback training plus intrarectal balloon training; 3) electromyographic biofeedback training plus home training; or 4) electromyographic biofeedback training, balloon training, and home training. All 36 patients received weekly one-hour outpatient biofeedback training. Success was measured by increased unassisted bowel movements and reduction in cathartic use. In all instances patients 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 Groups 1, 2, and 4 (P < 0.05) and a reduction in the use of cathartics in Groups 1, 2, and 3 (P < 0.05).
  
  
  CONCLUSIONS
  There was a significant improvement in outcome after all four treatment protocols for constipation; however, no significant difference was found among the treatments. Therefore, electromyographic biofeedback training alone is as effective as with the addition of balloon training, home training, or both.
authors.affiliation: Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale, USA.
authors.forename: S
authors.initials: S
authors.lastname: Heymen
authors.forename: S D
authors.initials: SD
authors.lastname: Wexner
authors.forename: D
authors.initials: D
authors.lastname: Vickers
authors.forename: J J
authors.initials: JJ
authors.lastname: Nogueras
authors.forename: E G
authors.initials: EG
authors.lastname: Weiss
authors.forename: A J
authors.initials: AJ
authors.lastname: Pikarsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001676:Biofeedback, Psychology / Q000379:methods*; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000503:physiopathology; D010045:Outpatients; D017773:Pelvic Floor / Q000503:physiopathology; D010528:Peristalsis; D010812:Physical Stimulation / Q000379:methods; D011446:Prospective Studies; D012007:Rectum / Q000503:physiopathology; D016896:Treatment Outcome