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Biofeedback therapy for rectal intussusception.
Tech Coloproctol 2006; 10(1):11-5; discussion 15-6TC

Abstract

BACKGROUND

Surgery for isolated internal rectal intussusception is controversial due to high morbidity. Therefore, there is interest in other forms of treatment that are safe and effective. The aim of this study was to determine outcome and identify predictors for success of biofeedback therapy in patients with rectal intussusception.

METHODS

We retrospectively evaluated the results of electromyography (EMG)-based biofeedback in 34 patients with rectal intussusception without any other major pelvic floor or colonic physiologic disorder.

RESULTS

A total of 34 patients (7 men) had undergone at least 2 biofeedback sessions. The patients had a mean age of 68.5 years (SD=11.4 years). In the 27 patients with constipation, the frequency of weekly spontaneous bowel movements (mean+/-SD) was 2.0+/-6.8 before and 4.1+/-4.6 after biofeedback (p<0.05). The frequency of weekly assisted bowel movements decreased from 3.8+/-3.5 before to 1.5+/-2.2 after therapy (p<0.005). The number of patients who experienced incomplete evacuation decreased from 17 (63%) to 9 (33%) (p<0.05). Thirty-three percent of patients had complete resolution of the symptoms, 19% had partial improvement, and 48% had no improvement. Patients with constipation lasting less than nine years had a 78% success rate vs. 13% in patients who were constipated more than 9 years (p<0.01). In seven patients with incontinence, the frequency of daily incontinence episodes decreased from 1.0+/-0.7 before to 0.07+/-0.06 after biofeedback (p<0.05). The fecal incontinence score decreased from 13.1+/-4.2 before to 4.6+/-3.6 after treatment (p<0.005). Two patients (29%) were completely continent following biofeedback, 2 had partial improvement, and 3 (43%) had no significant improvement. There was no mortality in either group.

CONCLUSIONS

Biofeedback is a safe and effective treatment option for constipation and fecal incontinence due to rectal intussusception in patients who are willing to complete the course of treatment. Long-standing constipation is less effectively cured by biofeedback.

Authors+Show Affiliations

Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL 33331, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16528489

Citation

Hwang, Y H., et al. "Biofeedback Therapy for Rectal Intussusception." Techniques in Coloproctology, vol. 10, no. 1, 2006, pp. 11-5; discussion 15-6.
Hwang YH, Person B, Choi JS, et al. Biofeedback therapy for rectal intussusception. Tech Coloproctol. 2006;10(1):11-5; discussion 15-6.
Hwang, Y. H., Person, B., Choi, J. S., Nam, Y. S., Singh, J. J., Weiss, E. G., ... Wexner, S. D. (2006). Biofeedback therapy for rectal intussusception. Techniques in Coloproctology, 10(1), pp. 11-5; discussion 15-6.
Hwang YH, et al. Biofeedback Therapy for Rectal Intussusception. Tech Coloproctol. 2006;10(1):11-5; discussion 15-6. PubMed PMID: 16528489.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biofeedback therapy for rectal intussusception. AU - Hwang,Y H, AU - Person,B, AU - Choi,J S, AU - Nam,Y S, AU - Singh,J J, AU - Weiss,E G, AU - Nogueras,J J, AU - Wexner,S D, Y1 - 2006/03/15/ PY - 2005/05/03/received PY - 2005/08/24/accepted PY - 2006/3/11/pubmed PY - 2006/10/27/medline PY - 2006/3/11/entrez SP - 11-5; discussion 15-6 JF - Techniques in coloproctology JO - Tech Coloproctol VL - 10 IS - 1 N2 - BACKGROUND: Surgery for isolated internal rectal intussusception is controversial due to high morbidity. Therefore, there is interest in other forms of treatment that are safe and effective. The aim of this study was to determine outcome and identify predictors for success of biofeedback therapy in patients with rectal intussusception. METHODS: We retrospectively evaluated the results of electromyography (EMG)-based biofeedback in 34 patients with rectal intussusception without any other major pelvic floor or colonic physiologic disorder. RESULTS: A total of 34 patients (7 men) had undergone at least 2 biofeedback sessions. The patients had a mean age of 68.5 years (SD=11.4 years). In the 27 patients with constipation, the frequency of weekly spontaneous bowel movements (mean+/-SD) was 2.0+/-6.8 before and 4.1+/-4.6 after biofeedback (p<0.05). The frequency of weekly assisted bowel movements decreased from 3.8+/-3.5 before to 1.5+/-2.2 after therapy (p<0.005). The number of patients who experienced incomplete evacuation decreased from 17 (63%) to 9 (33%) (p<0.05). Thirty-three percent of patients had complete resolution of the symptoms, 19% had partial improvement, and 48% had no improvement. Patients with constipation lasting less than nine years had a 78% success rate vs. 13% in patients who were constipated more than 9 years (p<0.01). In seven patients with incontinence, the frequency of daily incontinence episodes decreased from 1.0+/-0.7 before to 0.07+/-0.06 after biofeedback (p<0.05). The fecal incontinence score decreased from 13.1+/-4.2 before to 4.6+/-3.6 after treatment (p<0.005). Two patients (29%) were completely continent following biofeedback, 2 had partial improvement, and 3 (43%) had no significant improvement. There was no mortality in either group. CONCLUSIONS: Biofeedback is a safe and effective treatment option for constipation and fecal incontinence due to rectal intussusception in patients who are willing to complete the course of treatment. Long-standing constipation is less effectively cured by biofeedback. SN - 1123-6337 UR - https://www.unboundmedicine.com/medline/citation/16528489/Biofeedback_therapy_for_rectal_intussusception_ L2 - https://dx.doi.org/10.1007/s10151-006-0244-7 DB - PRIME DP - Unbound Medicine ER -