Improvement of Patient Satisfaction and Anorectal Manometry Parameters After Biofeedback Therapy in Patients with Differ
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Improvement of Patient Satisfaction and Anorectal Manometry Parameters After Biofeedback Therapy in Patients with Different Types of Dyssynergic Defecation Atefeh Talebi1 · Elaheh Alimadadi2 · Abolfazl Akbari1 · Mansour Bahardoust1,5 · Mohsen Towliat3 · Mahdi Eslami4 · Shahram Agah1 · Amirhossein Faghihi Kashani1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Biofeedback is a well-known and effective treatment for patients with fecal evacuation disorder (FED). The main purpose of this study was to investigate the outcome and the effects of biofeedback therapy on physiological parameters as assessed by manometry in patients with FED. Data from 114 consecutive patients with FED who underwent biofeedback therapy in Sara Gastrointestinal clinic in Tehran, Iran during 2015–2018 were retrospectively reviewed and analyzed. All participants underwent a comprehensive evaluation of anorectal function that included anorectal manometry and a balloon expulsion test at the baseline and after biofeedback therapy. Maximum anal squeeze pressure and sustained anal squeeze pressure were improved up to 100% and 94.7% of normal values in the patients after biofeedback, respectively (P 238 mmHg in male (Lee and Kim 2014)
Applied Psychophysiology and Biofeedback
Kim 2014). The balloon Expulsion time before and after biofeedback therapy was measured for each patient.
Biofeedback Protocol
Fig. 1 ARM catheter
defecation index DI ≤ 1.4, was considered as an abnormal test result. The mean of the three highest anal sphincter pressures at any level in the anal canal during rest and during squeeze was taken as the maximum resting and squeeze pressure (Noelting et al. 2012). In addition, dyssynergic pattern of defecation based on the ARM were classified into four types (Patcharatrakul and Rao 2018). In type I, patients could generate an adequate pushing force (≥ 40 mm Hg) along with a paradoxical increase in anal sphincter pressure during pushing. In type II, patients were unable to generate an adequate pushing force (
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