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Long-term efficacy of biofeedback therapy in patients with dyssynergic defecation: results of a median 44 months follow-up.
Neurogastroenterol Motil. 2015 Jun; 27(6):787-95.NM

Abstract

BACKGROUND

The beneficial effect of biofeedback therapy (BFT) over a period of more than 2 years has not been studied in a large group of patients. The aim of this study was to evaluate the long-term efficacy of BFT for dyssynergic defecation (DD).

METHODS

We evaluated the results for 347 consecutive constipated patients with DD who underwent BFT for a median of five sessions between 2004 and 2009. Initial responses were assessed immediately after the completion of BFT. A responder was defined as a subject with at least a three-point improvement from before to after BFT on an 11-point global bowel satisfaction (GBS) scale, or a two-point improvement if the baseline GBS was more than six points. The probability of remaining a responder was estimated by non-parametric maximum likelihood estimation.

KEY RESULTS

The initial response rate to BFT was 72.3% (n = 251), Parkinson's disease and higher baseline GBS scores were associated with initial non-response. The long-term efficacy of BFT was analyzed in 103 patients who were followed up for more than 6 months; the initial effects of BFT were maintained in 85 of the patients (82.5%) during a median of 44 months of follow-up (IQR = 12-68). The probability of remaining a responder was 60% at 2 years, and 58% at 5 years.

CONCLUSIONS & INFERENCES

The efficacy of BFT is maintained for more than 2 years after BFT in a considerable proportion of constipated patients with DD. BFT is effective and durable treatment for managing DD.

Authors+Show Affiliations

Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.Department of Gastroenterology, Asan Digestive Disease Research Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Pub Type(s)

Clinical Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25807997

Citation

Lee, H J., et al. "Long-term Efficacy of Biofeedback Therapy in Patients With Dyssynergic Defecation: Results of a Median 44 Months Follow-up." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 27, no. 6, 2015, pp. 787-95.
Lee HJ, Boo SJ, Jung KW, et al. Long-term efficacy of biofeedback therapy in patients with dyssynergic defecation: results of a median 44 months follow-up. Neurogastroenterol Motil. 2015;27(6):787-95.
Lee, H. J., Boo, S. J., Jung, K. W., Han, S., Seo, S. Y., Koo, H. S., Yoon, I. J., Park, S. H., Yang, D. H., Kim, K. J., Ye, B. D., Byeon, J. S., Yang, S. K., Kim, J. H., & Myung, S. J. (2015). Long-term efficacy of biofeedback therapy in patients with dyssynergic defecation: results of a median 44 months follow-up. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 27(6), 787-95. https://doi.org/10.1111/nmo.12552
Lee HJ, et al. Long-term Efficacy of Biofeedback Therapy in Patients With Dyssynergic Defecation: Results of a Median 44 Months Follow-up. Neurogastroenterol Motil. 2015;27(6):787-95. PubMed PMID: 25807997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term efficacy of biofeedback therapy in patients with dyssynergic defecation: results of a median 44 months follow-up. AU - Lee,H J, AU - Boo,S-J, AU - Jung,K W, AU - Han,S, AU - Seo,S Y, AU - Koo,H S, AU - Yoon,I J, AU - Park,S H, AU - Yang,D-H, AU - Kim,K-J, AU - Ye,B D, AU - Byeon,J-S, AU - Yang,S-K, AU - Kim,J-H, AU - Myung,S-J, Y1 - 2015/03/25/ PY - 2014/11/26/received PY - 2015/02/22/accepted PY - 2015/3/27/entrez PY - 2015/3/27/pubmed PY - 2016/2/18/medline KW - biofeedback therapy KW - constipation KW - dyssynergic defecation KW - treatment outcome SP - 787 EP - 95 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol. Motil. VL - 27 IS - 6 N2 - BACKGROUND: The beneficial effect of biofeedback therapy (BFT) over a period of more than 2 years has not been studied in a large group of patients. The aim of this study was to evaluate the long-term efficacy of BFT for dyssynergic defecation (DD). METHODS: We evaluated the results for 347 consecutive constipated patients with DD who underwent BFT for a median of five sessions between 2004 and 2009. Initial responses were assessed immediately after the completion of BFT. A responder was defined as a subject with at least a three-point improvement from before to after BFT on an 11-point global bowel satisfaction (GBS) scale, or a two-point improvement if the baseline GBS was more than six points. The probability of remaining a responder was estimated by non-parametric maximum likelihood estimation. KEY RESULTS: The initial response rate to BFT was 72.3% (n = 251), Parkinson's disease and higher baseline GBS scores were associated with initial non-response. The long-term efficacy of BFT was analyzed in 103 patients who were followed up for more than 6 months; the initial effects of BFT were maintained in 85 of the patients (82.5%) during a median of 44 months of follow-up (IQR = 12-68). The probability of remaining a responder was 60% at 2 years, and 58% at 5 years. CONCLUSIONS & INFERENCES: The efficacy of BFT is maintained for more than 2 years after BFT in a considerable proportion of constipated patients with DD. BFT is effective and durable treatment for managing DD. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/25807997/Long_term_efficacy_of_biofeedback_therapy_in_patients_with_dyssynergic_defecation:_results_of_a_median_44_months_follow_up_ L2 - https://doi.org/10.1111/nmo.12552 DB - PRIME DP - Unbound Medicine ER -