Curbside Consultation of the Colon: 49 Clinical Questions

Brooks D. Cash, MD, FACP, CDR, MC, USN

Question 18: A Patient Asks About Biofeedback Therapy For Her Constipation Symptoms And Wants To Know What Is Involved. What Do I Tell Her? (continued)

Erica Roberson, MD; Arnold Wald, MD

Biofeedback is an effective therapy specifically for chronic constipation secondary to dyssynergic defecation. Normal defecation involves a coordinated cascade of events: intra-abdominal pressures increase while anal canal pressures decrease and pelvic floor muscles relax in order to widen the anorectal angle. In some patients, the anal sphincters do not relax or actually contract, resulting in an increase in anal canal pressure, the puborectalis muscle does not relax or actually contracts to narrow the anorectal angle, and/or inadequate intra-abdominal pressures are generated. Dyssynergic…