Narayanan Susrutha Puthanmadhom, Bharucha Adil E
Clinical Enteric Neuroscience Translational and Epidemiological Research Program, Division of Gastroenterology and Hepatology, Mayo Clinic, 200 1st Street, Rochester, MN, 55905, USA.
Curr Gastroenterol Rep. 2019 Apr 23;21(5):21. doi: 10.1007/s11894-019-0688-3.
Biofeedback therapy (BFT) is effective for managing pelvic floor disorders (i.e., defecatory disorders and fecal incontinence). However, even in controlled clinical trials, only approximately 60% of patients with defecatory disorders experienced long-term improvement. The review serves to update practitioners on recent advances and to identify practical obstacles to providing biofeedback therapy.
The efficacy and safety of biofeedback therapy have been evaluated in defecatory disorders, fecal incontinence, and levator ani syndrome. Recent studies looked at outcomes in specific patient sub-populations and predictors of a response to biofeedback therapy. Biofeedback therapy is effective for managing defecatory disorders, fecal incontinence, and levator ani syndrome. Patients who have a lower bowel satisfaction score and use digital maneuvers fare better. Biofeedback therapy is recommended for patients with fecal incontinence who do not respond to conservative management. A subset of patients with levator ani syndrome who have dyssynergic defecation are more likely to respond to biofeedback therapy.
生物反馈疗法(BFT)对管理盆底功能障碍(即排便障碍和大便失禁)有效。然而,即使在对照临床试验中,只有约60%的排便障碍患者实现了长期改善。本综述旨在向从业者介绍最新进展,并找出提供生物反馈疗法的实际障碍。
生物反馈疗法的有效性和安全性已在排便障碍、大便失禁和肛提肌综合征中得到评估。近期研究关注了特定患者亚组的治疗结果以及生物反馈疗法反应的预测因素。生物反馈疗法对管理排便障碍、大便失禁和肛提肌综合征有效。肠道满意度评分较低且采用手法辅助排便的患者效果更佳。对于对保守治疗无反应的大便失禁患者,推荐使用生物反馈疗法。一部分存在排便协同失调的肛提肌综合征患者更可能对生物反馈疗法有反应。