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Objectives <p>Functional defecation disorders (FDD), a major sub-type of chronic constipation, often exhibit limited response to pharmacotherapy. Anorectal biofeedback therapy (BFT) is the recommended therapy, but there is limited data regarding its long-term effectiveness and predictors of response. We evaluated the short and long-term effectiveness of a six-session anorectal BFT protocol in patients with FDD.</p> Methods <p>In this ambispective cohort study (2018–2024), adult patients diagnosed with FDD by Rome-IV criteria who completed six BFT sessions were included. The primary outcome was at&#xa0;least 30% improvement in the Modified Cleveland Constipation (MCC) score. Secondary outcomes included changes in symptoms on visual analog scale (VAS), individual symptoms, anorectal manometry parameters and predictors of response to BFT. The patients who had completed at least one-year follow-up were contacted to assess long-term response.</p> Results <p>One hundred sixty-six patients were included (median age = 40&#xa0;years [IQR = 27–52]; 69.3% male). After BFT, 61.4% achieved improvement in MCC score by &gt; 30%, with significant improvement in VAS score and individual symptoms such as incomplete evacuation, straining and manual evacuation (<i>p</i> &lt; 0.001). Post biofeedback, there was significant increase in defecation index and anal relaxation (<i>p</i> &lt; 0.001). Younger age was predictive of short-term response to BFT regardless of different sub-types of FDD<i>.</i> At long-term follow-up of 110 patients (median = 22&#xa0;months, IQR = 12–28&#xa0;months), 56.4% reported sustained improvement in MCC score by &gt; 30%, with initial response to BFT being significant predictor of long-term response.</p> Conclusions <p>Anorectal BFT is an effective treatment for FDD with sustained benefit over long term.</p> Graphical Abstract <p></p>

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Short and long-term outcomes of anorectal biofeedback therapy in patients with functional defecation disorders: Efficacy and predictors of response

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Ayush Agarwal,
  • Abhijith K. Anil,
  • Rajkumar Bayye,
  • Ashish Agarwal,
  • Ashish Chauhan,
  • Samagra Agarwal,
  • Ritesh Netam,
  • Soumya Jagannath Mahapatra,
  • Saurabh Kedia,
  • Deepak Gunjan,
  • Shalimar,
  • Vineet Ahuja,
  • Pramod Kumar Garg,
  • Ashok Kumar Jaryal,
  • Govind K. Makharia

摘要

Objectives

Functional defecation disorders (FDD), a major sub-type of chronic constipation, often exhibit limited response to pharmacotherapy. Anorectal biofeedback therapy (BFT) is the recommended therapy, but there is limited data regarding its long-term effectiveness and predictors of response. We evaluated the short and long-term effectiveness of a six-session anorectal BFT protocol in patients with FDD.

Methods

In this ambispective cohort study (2018–2024), adult patients diagnosed with FDD by Rome-IV criteria who completed six BFT sessions were included. The primary outcome was at least 30% improvement in the Modified Cleveland Constipation (MCC) score. Secondary outcomes included changes in symptoms on visual analog scale (VAS), individual symptoms, anorectal manometry parameters and predictors of response to BFT. The patients who had completed at least one-year follow-up were contacted to assess long-term response.

Results

One hundred sixty-six patients were included (median age = 40 years [IQR = 27–52]; 69.3% male). After BFT, 61.4% achieved improvement in MCC score by > 30%, with significant improvement in VAS score and individual symptoms such as incomplete evacuation, straining and manual evacuation (p < 0.001). Post biofeedback, there was significant increase in defecation index and anal relaxation (p < 0.001). Younger age was predictive of short-term response to BFT regardless of different sub-types of FDD. At long-term follow-up of 110 patients (median = 22 months, IQR = 12–28 months), 56.4% reported sustained improvement in MCC score by > 30%, with initial response to BFT being significant predictor of long-term response.

Conclusions

Anorectal BFT is an effective treatment for FDD with sustained benefit over long term.

Graphical Abstract