Efficacy of conventional treatments combined with biofeedback therapy in patients with constipation-predominant irritable bowel syndrome

Introduction. The mainstay of treatment of constipation-predominant irritable bowel syndrome (IBS-C) are antispasmodic and laxative drugs. The use of biofeedback therapy is effective in patients with IBS-C, when dyssynergic defecation (DD) is detected. Aim. To evaluate the efficacy of additional biofeedback therapy in patients with IBS-C and dyssynergic defecation versus conventional pharmacotherapy. Materials and methods. A total of 28 patients aged 30 to 40 years with IBS-C and concomitant DD were included in the study. The subjects were divided into two groups: standard pharmacotherapy (Group 1) and standard pharmacotherapy combined with biofeedback therapy (Group 2). The subjects underwent assessment of the clinical picture, and findings of the evacuation test (ET) and anorectal manometry (AM). Results. After treatment the frequency of defecations per week in Group 1 increased to 3.13 (95% CI 2.67–3.59), and in Group 2 to 4.3 (95% CI 3.68–4.93). AM data showed a decrease in average resting pressure in the anal canal to 80.33 (95% CI 72.97– 87.69) (Group 1), and to 77.15 (95% CI 72.07–82.23) mm Hg (Group 2), an increase in intrarectal pressure to 78.06 (95% CI 69.30–86.82) (group 1) and to 70.76 (95% CI 63.08–78.44) mm Hg (Group 2). In Group 2, the defecation index increased to 2.61 (95% CI 2.0-3.22) versus 1.19 (95% CI 0.92-1.44) in Group 1, positive ET was reported in 5 of 15 subjects (33.33%) in Group 1, and in 10 of 13 subjects (76.92%) in Group 2. Conclusions. This study shows that conventional pharmacotherapy combined with biofeedback therapy demonstrated greater efficacy than standard pharmacotherapy in patients with IBS-C and DD.