A new therapy, known as biofeedback, has just been proven on 70% of patients with chronic constipation.
Constipation is a common problem, which can be very painful and disabling. When chronic, it may correspond to “dyssynergic defecation” (about 30% of cases), and standard treatments such as more fiber in the diet, stool softeners and laxatives do not work. Some have these problems since childhood, and others have developed them later, following episodes in life such as pregnancy, back problems or hemorrhoids.
Re-coordinate the muscles
This new therapy, known as biofeedback, has just been proven in patients suffering from “chronic dyssynergic constipation” or pelvic floor dysfunction: 68% if the technique is performed at home and 70% if it is performed at home. ‘hospital. She simply learns to re-coordinate the abdominal, pelvic and intestinal muscles. It allows “to find the natural rhythm of contraction of the muscles of the upper rectum to evacuate the stool while relaxing the muscles at the anal opening so that the stool can come out”, explains Rao J. Harold Harrison, gastroenterologist and director of the ‘study.
Having a bowel movement is indeed a physiological process that can be divided into several sequences. When people who are not constipated go to the toilet, they increase the intra-abdominal and intra-rectal pressures and, at the same time, they relax the pelvic muscles and the anal opening. This opening is hurt in dyssynergic constipation: “When patients with dyssynergia try to have a bowel movement, they push them back or simply hold them without their knowledge”, specifies Rao J. Harold Harrison.
Asynchrony of contractions
It is therefore an ineffective habit when you have a bowel movement and which is acquired without wanting it: the abdominal muscles distend while the pelvic floor contracts: these efforts no longer manage to pass the stool through the strong muscular barrier of the pelvis.
The pelvic floor is made up of muscles that help control defecation. Good coordination of bowel movements requires the synchronization of light and deep contractions of the abdominal and intestinal muscles, and complete relaxation of the pelvic floor. The puborectalis muscle, which acts as a sling since when it is at rest, increases the angle between the rectum and the anus to help with defecation. The external anal sphincter and the puborectalis muscle must relax at the same time to allow defecation.
home therapy
The American Gastroenterology Association, the American Neurogastroenterology and Motility Society and the European Society of Neurogastroenterology and Motility have all endorsed this new treatment. To achieve these results, 100 patients tested the biofeedback therapy at home, others in a doctor’s office. Half were randomly assigned to each group from January 2005 to January 2010. Correction of the constipation problem was observed in 72% of the home therapy group and 80% of the office group.
In Western countries, the number of people suffering from chronic constipation is estimated between 3% and 5% of the adult population. If we extend this statistic to all constipated people (all types of constipation combined: occasional constipation and chronic constipation), this figure is between 10% and 30% of the adult population. Untreated, constipation can have serious consequences, such as bowel obstruction, anal fissures or faecal incontinence.
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