Sunić-Omejc M, Mihanović M, Bilić A, Jurcić D, Restek-Petrović B, Marić N, Dujsin M, Bilić A
Children's Hospital Zagreb, Zagreb, Croatia.
Coll Antropol. 2002 Dec;26 Suppl:93-101.
Chronic constipation is a common disorder in childhood. The underlying mechanisms responsible for chronic constipation remain unknown. Conventional methods of treatment often fail to produce satisfactory results. Favorable effects of biofeedback treatment for constipation have been suggested, however, with variable results reported in the literature. The main aim of the study was to evaluate biofeedback versus conventional therapeutic protocol in the treatment of chronic constipation over a short period of time (3 months). Forty-nine children with chronic idiopathic constipation, 24 allocated to conventional and 25 to biofeedback therapy were included in the study. Thorough history data on bowel function and symptoms, anorectal status and manometric testing were collected before and after treatment. Follow up consisted of a structured interview. Mean age was 94 and 92 months in the children treated by the conventional and biofeedback method, respectively. The initial prevalence of abnormal defecation dynamics was 58% and 56% in the group children allocated to conventional and biofeedback therapy, respectively. The difference was not statistically significant. After the treatment, the values of rectal sensation threshold, critical volume, and recto-anal inhibitory reflex volume were significantly higher, and the prevalence of abnormal defecation dynamics was significantly lower in the group on biofeedback therapy. Biofeedback is an effective method of treatment for chronic constipation in children in short term. Therapeutic results are especially favorable in the recovery of abnormal anorectal dynamics and manometric parameters. There is no clear evidence for long-term benefits of biofeedback therapy.
慢性便秘是儿童期的常见病症。导致慢性便秘的潜在机制尚不清楚。传统治疗方法往往无法产生令人满意的效果。然而，已有研究表明生物反馈疗法对便秘有积极作用，但文献报道的结果不一。本研究的主要目的是在短时间内（3个月）评估生物反馈疗法与传统治疗方案治疗慢性便秘的效果。本研究纳入了49例慢性特发性便秘儿童，其中24例接受传统治疗，25例接受生物反馈治疗。在治疗前后收集了关于肠道功能和症状、肛门直肠状况及测压检查的详细病史数据。随访采用结构化访谈。接受传统治疗和生物反馈治疗的儿童平均年龄分别为94个月和92个月。分配到传统治疗组和生物反馈治疗组的儿童中，排便动力学异常的初始患病率分别为58%和56%。差异无统计学意义。治疗后，生物反馈治疗组的直肠感觉阈值、临界容量和直肠-肛门抑制反射容量值显著升高，排便动力学异常的患病率显著降低。生物反馈疗法是短期内治疗儿童慢性便秘的有效方法。在恢复异常的肛门直肠动力学和测压参数方面，治疗效果尤为显著。目前尚无明确证据表明生物反馈疗法具有长期益处。
