title: Biofeedback avoids surgery in patients with slow-transit constipation: report of four cases.
abstract: Biofeedback is established treatment for intractable constipation in patients with an element of pelvic floor dysfunction. In those with intractable slow-transit constipation and normal pelvic floor function, colectomy is usually recommended. We report four patients with isolated slow-transit constipation who benefited from biofeedback and avoided surgery. All four patients were extensively investigated for pelvic floor dysfunction before undergoing a standard biofeedback course of four outpatient sessions. All improved in terms of bowel frequency, laxative use, bloating, straining, and lifestyle. Improvement has been maintained for a median of nine (range, 5-12) months without the requirement for further treatment. Biofeedback represents a safe and inexpensive treatment for these patients and may avoid surgery in a significant proportion.
authors.affiliation: Department of Colorectal Surgery, Singapore General Hospital, Singapore.
authors.forename: S R
authors.initials: SR
authors.lastname: Brown
authors.forename: D
authors.initials: D
authors.lastname: Donati
authors.forename: F
authors.initials: F
authors.lastname: Seow-Choen
authors.forename: Y H
authors.initials: YH
authors.lastname: Ho
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology; D003248:Constipation / Q000523:psychology / Q000628:therapy*; D003672:Defecation; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000294:innervation / Q000502:physiology*; D016896:Treatment Outcome