Effects of adaptive biofeedback training on long-term efficacy and family maintenance treatment in patients with outlet obstruction constipation

Objective To explore the effects of adaptive biofeedback training (ABF) on long-term efficacy and family maintenance treatment in patients with outlet obstruction constipation (OOC). Methods From October 2010 to April 2013, a total of 114 patients with OOC met Rome Ⅲ criteria were enrolled in this study. After six weeks ABF treatment, patients were divided into family maintenance treatment group and simple follow-up group. And then the scores of clinical constipation symptoms, weekly dosage of polyethylene glycol electrolyte powder, total clinical efficacy and satisfaction rate were recorded. T test and chi-square test were performed for statistical analysis. Results A total of 95 patients with OOC were enrolled in the follow-up study eventually, 42 cases in family maintenance treatment group and 53 cases in simple follow-up group. After six weeks ABF treatment, the scores of clinical constipation symptoms and weekly dosage of polyethylene glycol electrolyte powder decreased in both two groups. At 36th month after six weeks ABF, in family maintenance treatment group, the score of clinical constipation symptoms and weekly dosage of polyethylene glycol electrolyte powder were 4.86±1.13 and (5.88±1.14) packs, respectively, which were both lower than those before treatment (11.05±3.26 and (15.28±4.12) packs, respectively), and the differences were statistically significant (t=2.520, P=0.041; t=3.080, P=0.042). At 36th month after six weeks ABF, in simple follow-up group, the score of clinical constipation symptoms and weekly dosage of polyethylene glycol electrolyte powder were (7.12±1.25) and (11.44±2.88) packs, compared with those before treatment (11.07±2.86 and (15.77±3.78) packs), the difference was not statistically significant (both P>0.05). At 36th month after six weeks ABF, in family maintenance treatment group, the total clinical efficacy and total satisfaction rates both were 71.4% (30/42), compared with those at the end of treatment (88.1% (37/42), 83.3% (35/42)), the difference was not statistically significant (both P>0.05). In simple follow-up group, at 12th month after six weeks ABF, the total clinical efficacy and satisfaction rates were 69.8% (37/53) and 66.0% (35/53), compared with those at the end of treatment (88.7%(47/53) and 84.9%(45/53)), the difference was not statistically significant (both P>0.05), at 24th months, the total clinical efficacy and satisfaction rates were 49.1% (26/53) and 47.2% (25/53), which were both lower than those at the end of treatment, and the differences were statistically significant (χ2 =1.762, P=0.036; χ2 =1.928, P=0.041). Conclusions The efficacy of ABF in the treatment of patients with OOC lasts less than two years. However, the family maintenance treatment can keep for three years, which may be an effective method to keep long-term efficacy in patients with OOC. Key words: Biofeedback (psychology); Treatment outcome; Chronic constipation; Gastrointestinal motility