title: Effect of biofeedback therapy in constipation according to rectal sensation.
abstract: OBJECTIVE
  The pathophysiologic mechanism of rectal hyposensitivity (RH) is not well documented, and the significance of RH in biofeedback therapy (BFT) has not been evaluated. Thus, we aimed to assess the effect of BFT in constipated patients according to the presence of RH.
  
  
  METHODS
  Five hundred and ninety constipated patients (238 males and 352 females) underwent anorectal physiologic assessments. Of these, anorectal manometry was performed before and after BFT in 244 patients (63 RH and 181 non-RH patients).
  
  
  RESULTS
  The success rate of BFT was 56% in the RH and 61% in the non-RH group (p=0.604). The measurements of resting pressure, squeezing pressure, desire to defecate volume, urge to defecate volume, and maximum volume were decreased after BFT in the RH group (p<0.05), whereas only resting and squeezing pressures were decreased in the non-RH group (p<0.05). Among the RH group, individuals who responded to BFT showed decreased resting pressure, squeezing pressure, desire to defecate, urge to defecate, and maximum volume and increased balloon expulsion rate; among those who did not respond to BFT, only desire to defecate volume was improved.
  
  
  CONCLUSIONS
  In constipated patients with RH, changes of anorectal manometric findings differed in comparison to patients without RH. The responses to BFT showed both anorectal muscle relaxation and restoration of rectal sensation.
authors.affiliation: Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Ahn
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
authors.forename: Kee Wook
authors.initials: KW
authors.lastname: Jung
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.forename: Hyun Sook
authors.initials: HS
authors.lastname: Koo
authors.forename: So Young
authors.initials: SY
authors.lastname: Seo
authors.forename: In Ja
authors.initials: IJ
authors.lastname: Yoon
authors.forename: Kyung Jo
authors.initials: KJ
authors.lastname: Kim
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
keywords: Anorectal manometry; Biofeedback; Constipation; Rectum; Sensation
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