Enrolling by invitation
Not applicable
Biofeedback for Women With Dyssynergic Defecation (DD)
Condition(s) studied
Dyssenergic DefecationStraining, Hard Stools, Incomplete Evacuation
Investigational drug(s) / intervention(s)
Lifestyle management in form of stretching positions and patient's education position of defecation
Lifestyle management in form of stretching positions and patient's education position of defecation: 1. Stretching Positions: \*Child's Pose\*\* Reverse Kegel Exercises \*\*\*Supine Piriformis Stretch.
2. Education Defecation Position: patient sit with her knees positioned higher than hips, use a small footstool. Lean forward from the hips and rest your forearms on thighs.
3. Rectal Massage: Using a water-based lubricant and a clean, gloved finger, therapist can gently massage the internal anal sphincter to encourage it to relax.
4. Anal Dilators: patient lie on her side or back with pillows under knees. Apply a generous amount of water-based lubricant to both the dilator and anal area. Ask patient to gently bear down as if passing gas and insert the tip. Pause if she feel the muscle contract or guard, ask her to focus on breathing, and wait for the muscle to soften before inserting it further.Once fully inserted, ask her to breathe in deeply to distend her belly, then exhale while maintaining abdominal distention. Visualize the pelvic floor dropping.
Study summary
This research aimed to compare the effect of Biofeedback (BFB) versus Lifestyle management in form of stretching positions and patient's education position of defecation, in addition to rectal massage, and anal dilators among Dyssynergic Defecation (DD) in Females. It is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools
Eligibility
Inclusion Criteria:
* Female patients aged between 35-65 years, their BMI 30-34 kg/m2, they are suffering from DD, have ability to perform BFB, and cooperative and capable of providing informed consent. namely two or more of 6 symptoms present for the last 3 months with an onset more than 6 months in the past; the symptoms are: straining, lumpy or hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction/blockage, or manual manoeuvres to facilitate defecation, or less than 3 bowel movements per week. All the included patients will have selected to be unresponsive to dietary modification, life style modification, and laxatives for a period of at least 3 months.
Exclusion Criteria:
* Significant anatomical issues such as a large rectocele, full rectal prolapse, active anal fissures, severe internal anal sphincter injuries, or anorectal neoplasia, history of recent anal region surgery (e.g., within the last 6 months), history of previous gastrointestinal, spinal, or pelvic surgery, neurological diseases that affect bowel function, such as multiple sclerosis, stroke, spinal cord injury, or Parkinson's disease, severe cardiac, renal, or chronic obstructive pulmonary disease (COPD), inflammatory bowel disease (Crohn's disease or ulcerative colitis), diabetes mellitus, or thyroid dysfunction. Use of opioids within a specified recent period (e.g., the previous 2 weeks or not on a stable dose). Use of medications known to cause constipation or interfere with the study, such as certain antidepressants or analgesics. Recent history (e.g., within 6 months) of Botox injections for pelvic floor issues. Pregnancy, Impaired cognition or mental health issues (e.g., severe depression, psychotic disorders, cognitive disability) that would prevent understanding and cooperation with the treatment. Alternating patterns of constipation and diarrhea, which may indicate Irritable Bowel Syndrome (IBS) without a clear constipation subtype.
Primary outcome measure(s)
- 1- Resting anal pressure. 2-Maximum straining anal pressure during an attempted defecation (bearing down). — The measurements will be taken at baseline and after 6 weeks of intervention
These variables will be done by using the EMG Biofeedback device: (Gymna Myo 200). This is the primary test to assess the pressure activity and coordination of the rectal and anal muscles. A small, flexible probe will be inserted into the rectum. The test will measure rectal pressure and anal sphincter pressure changes, using Millimeters of mercury (mmHg). In DD, it typically shows inadequate pushing force, paradoxical anal sphincter contraction, or insufficient relaxation.
Trial sites (1)
| Facility | City | Region | Status |
|---|
| Ahram Canadian University |
Giza |
Cairo Governorate |
|
More Ahram Canadian University trials in Egypt