Preview

Koloproktologia

Advanced search

DIAGNOSIS AND CONSERVATIVE TREATMENT OF FUNCTIONAL DISORDERS OF DEFECATION

https://doi.org/10.33878/2073-7556-2016-0-3-48-54

Abstract

90 patients (female 72 (80%), male 18 (20%), mean age 43,6±16,5 y.o.) with functional disorders of defecation (dyssynergic defecation and inadequate propulsion) were included in the study. All the patients conformed the Rome III (2006) criteria for functional constipation. Highresolution anorectal manometry (HRAM) procedures (London protocol) were performed using Solar GI system (MMS, The Netherland) with 8-channel water-perfusion catheters. All the patients underwent a course of biofeedback therapy for obstructive defecation (Urostim, Laborie, Canada). The course consisted of 10 daily 30-minutes long sessions. Treatment efficacy was evaluated after the completion of biofeedback therapy according to the control HRAM. CONCLUSIONS. Biofeedback is the method of choice for treatment of patients with obstructive defecation syndrome with pelvic floor dyssynergia and spasm of m.puborectalis. At the same time biofeedback therapy is ineffective in patients with type III of manometry pattern and in patients with an inadequate propulsion.

About the Authors

O. U. Fomenko
State Scientific Center of Coloproctology
Russian Federation


A. U. Titov
State Scientific Center of Coloproctology
Russian Federation


O. M. Birukov
State Scientific Center of Coloproctology
Russian Federation


A. A. Mudrov
State Scientific Center of Coloproctology
Russian Federation


S. V. Belousova
State Scientific Center of Coloproctology
Russian Federation


D. V. Egorova
State Scientific Center of Coloproctology
Russian Federation


References

1. Орлова Л.П., Зароднюк И.В., Кузьминов А.М. и соавт. Особенности лучевой диагностики ректоцеле. Медицинская визуализация. - 2006. - № 1. - с. 98-102.

2. Шелыгин Ю.А., Бирюков О.М., Титов А.Ю. и соавт. Существуют ли предикторы результатов хирургического лечения ректоцеле? Колопроктология. - 2015. - 1 (51). - с. 64-69.

3. Rao S.S. Biofeedback therapy for constipation in adults. Best Pract. Res. Clin. Gastroenterology. - 2011; 25: 159-166.

4. Appendix A. Rome III Diagnostic Criteria for FGIDs 893.

5. Bartolo D., Roe A. Obstructed defaecation. Br. J. Hosp. Me. - 1986; 35: 228-236.

6. Bharucha A.E., Wald A., Enck P. et al. Functional Anorectal Disorders. Gastroenterology. - 2006; 130: 1510-1518.

7. Bharucha A.E., Pemberton J.H., Locke G.R., 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. - 2013; 144 (1): 218-238.

8. Bleijenberg G., Kuijpers H.C. Treatment of spastic pelvic floor syndrome with biofeedback. Dis. Colon Rectum. - 1987; 36: 108-111.

9. Bove A., Pucciani F., Bellini M. et al. Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J. Gastroenterol. - 2012 Apr; 14; 18 (14): 1555-64.

10. Carrington E.V., Brokjaer A., Craven H. et al. Traditional measures of normal anal sphincter function using high-resolution anorectal manometry (HRAM) in 115 healthy volunteers. Neurogastroenterol. Motil. -2014 May; 26 (5): 625-35.

11. Chiarioni G., Whitehead W.E., Pezza V. et al. Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology. - 2006; 130: 657-664.

12. Conklin J., Pimentel M., Soffer Е. Color Atlas of High Resolution Manometry. Springer: Los-Angeles, 2011. - 104 р.

13. DiCara L.V., Miller N.E. Instrumental learning of systolic blood pressure responses by curarized rats: Dissociation of cardiac and vascular changes. Psychosomatic Medicine. - 1968; 30: 489-494.

14. Drossman D.A. The functional gastrointestinal disorders and the Rome III. Gastroenterology - 2006, Apr; 130 (5): 1377-1390.

15. Ellis C.N., Essani R. Treatment of obstructed defecation. Clin. Colon Rectal Surg, - 2012. 25 (1): 24-33.

16. Enck P., Van der Voort I.R., Klosterhalfen S. Biofeedback therapy in fecal incontinence and constipation. Neurogastroenterol. Motil. - 2009; 21: 1133-1141.

17. Enck P. Biofeedback training in disordered defecation: a critical review. Dig. Dis. Sci. - 1993; 38: 1953-1960.

18. Gallagher P., O’Mahony D. Constipation in old age. Best Pract. Res. Clin. Gastroenterol. - 2009; 23 (6): 875-887.

19. Higgins P.D., Johanson J.F. Epidemiology of constipation in North America: a systematic review. Am. J. Gastroenterol. - 2004; 99: 750-759.

20. http://www.aapb.org/

21. Kamiya J. Conscious control of brain wave. Psychol. Today. - 1968; 1: 56-60. _

22. Kinnunen O. Study of constipation in a geriatric hospital, day hospital, old people’s home and at home: Aging (Milano). - 1991; 3: 161-170.

23. Kuijpers H.C., Bleijenberg G. The spastic pelvic floor syndrome. A cause of constipation. Dis. Colon Rectum. - 1985; 28 (9): 669-72.

24. Preston D.M., Lennard-Jones J.E. Anismus in chronic constipation. Dig. Dis. Sci. - 1985; 30 (5): 413-418.

25. Pucciani F., Altomare D.F., Dodi G. et al. Obstructed defaecation: what is the role of rehabilitation? Colorectal Dis. - 2011; 14: 474-479.

26. Rao S.S. Dyssynergic Defecation: Questions and Answers About a Common Cause of Chronic Constipation. IFFGD Publication #237 (2009-2012).

27. Rao S.S., Seaton K., Miller M. et al. Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation. Clin. Gastroenterol. Hepatol. - 2007; 5: 331-338.

28. Rao S.S., Welcher K.D., Leistikow J.S. Obstructive defecation: a failure of rectoanal coordination. Am. J. Gastroenterol. - 1998; 93: 1042-1050.

29. Rao S.S., Welcher K.D., Pelsang R.E. Effects of biofeedback therapy on anorectal function in obstructive defecation. Dig. Dis. Sci. - 1997; 42: 2197-2205.

30. Rosen A. Obstructed Defecation Syndrome: Diagnosis and Therapeutic Options, with Special Focus on the STARR Procedure. Isr. Med. Assoc J. - 2010 Feb; 12 (2): 104-106.

31. Schwandner O., Stuto A., Jayne D. et al. Decisionmaking algorithm for the STARR procedure in obstructed defecation syndrome: position statement of the group of STARR Pioneers. Surg. Innov. - 2008; 15: 105-109.

32. Sterman M.B., White L., Tursky B. EEG biofeedback in the treatment of epilepsy: An overview circa 1980. In: Clinical Biofeedback: Efficacy and Mechanism - 1982, p. 330-331.

33. Turnbull G.K., Ritvo P.G. Anal sphincter biofeedback relaxation treatment for women with intractable constipation symptoms. Dis. Colon Rectum. - 1992: 35: 530-536.

34. Wald A., Caruana B. J., Freimanis M. G. et al. Contributions of evacuation proctography and anorectal manometry to evaluation of adults with constipation and defecatory difficulty. Dig. Dis. Sci. - 1990. 35 (4): 481-487.

35. Weber J., Ducrotte P., Touchais J.Y. et al. Biofeedback training for constipation in adults and children. Dis. Colon Rectum. - 1987; 30: 844-846.

36. Zhang B., Ding J.H., Yin S.H. et al. Stapled transanal rectal resection for obstructed defecation syndrome associated with rectocele and rectal intussusception. World J. Gastroenterol. - 2010 May 28; 16 (20): 2542-2548.


Review

For citations:


Fomenko O.U., Titov A.U., Birukov O.M., Mudrov A.A., Belousova S.V., Egorova D.V. DIAGNOSIS AND CONSERVATIVE TREATMENT OF FUNCTIONAL DISORDERS OF DEFECATION. Koloproktologia. 2016;(3):48-54. (In Russ.) https://doi.org/10.33878/2073-7556-2016-0-3-48-54

Views: 1555


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2073-7556 (Print)
ISSN 2686-7303 (Online)