Biofeedback for pelvic floor dysfunction in constipation

Abstract

Chronic constipation is a common self reported gastrointestinal problem that affects between 2% and 34% of adults in various populations studied. Among the subtypes of constipation, obstructed defecation seems particularly common, occurring in about 7% of the adult population.1 In most people with this conditionan inappropriate (paradoxical) contraction or a failed relaxation of the puborectal muscle and of the external anal sphincter often occurs during attempts to defecate (fig 1). This paradoxical contraction of the pelvic floor muscles during straining at defecation is considered a form of maladaptive learning and is generally defined (without specifying the underlying pathophysiological mechanism) as outlet dysfunction constipation or, more precisely, pelvic floor dyssynergia.2