title: Predictive capability of anorectal physiologic tests for unfavorable outcomes following biofeedback therapy in dyssynergic defecation.
abstract: The purpose of this study is to evaluate the predictive capability of anorectal physiologic tests for unfavorable outcomes prior to the initiation of biofeedback therapy in patients with dyssynergic defecation. We analyzed a total of 80 consecutive patients who received biofeedback therapy for chronic idiopathic functional constipation with dyssynergic defecation. After classifying the patients into two groups (responders and non-responders), univariate and multivariate analyses were performed to determine the predictors associated with the responsiveness to biofeedback therapy. Of the 80 patients, 63 (78.7%) responded to biofeedback therapy and 17 (21.3%) did not. On univariate analysis, the inability to evacuate an intrarectal balloon (P=0.028), higher rectal volume for first, urgent, and maximal sensation (P=0.023, P=0.008, P=0.007, respectively), and increased anorectal angle during squeeze (P=0.020) were associated with poor outcomes. On multivariate analysis, the inability to evacuate an intrarectal balloon (P=0.018) and increased anorectal angle during squeeze (P=0.029) were both found to be independently associated with a lack of response to biofeedback therapy. Our data show that the two anorectal physiologic test factors are associated with poor response to biofeedback therapy for patients with dyssynergic defecation. These findings may assist physicians in predicting the responsiveness to therapy for this patient population.
authors.affiliation: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae Kook
authors.initials: JK
authors.lastname: Shin
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cheon
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Kim
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Yoon
authors.forename: Jin Ha
authors.initials: JH
authors.lastname: Lee
authors.forename: Soung Min
authors.initials: SM
authors.lastname: Jeon
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Bok
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Park
authors.forename: Chang Mo
authors.initials: CM
authors.lastname: Moon
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Hong
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Lee
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology*; D001259:Ataxia / Q000503:physiopathology* / Q000628:therapy; D001676:Biofeedback, Psychology; D003248:Constipation / Q000503:physiopathology / Q000628:therapy; D003672:Defecation / Q000502:physiology*; D019841:Defecography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012007:Rectum / Q000503:physiopathology*; D016896:Treatment Outcome