Efficacy and Predictors for Biofeedback Therapeutic Outcome in Patients with Dyssynergic Defecation

AIM: To evaluate the short-term efficacy of biofeedback therapy (BFT) for dyssynergic defecation (DD) and to explore the predictors of the efficacy of BFT. METHODS: Clinical symptoms, psychological state, and quality of life of patients before and after BFT were investigated. All patients underwent lifestyle survey and anorectal physiology tests before BFT. Improvement in symptom scores was considered proof of clinical efficacy of BFT. Thirty-eight factors that could influence the efficacy of BFT were studied. Univariate and multivariate analysis was conducted to identify the independent predictors. RESULTS: Clinical symptoms, psychological state, and quality of life of DD patients improved significantly after BFT. Univariate analysis showed that efficacy of BFT was positively correlated to one of the 36-item Short-Form Health Survey terms, the physical role function (r = 0.289; P = 0.025), and negatively correlated to the stool consistency (r = −0.220; P = 0.032), the depression scores (r = −0.333; P = 0.010), and the first rectal sensory threshold volume (r = −0.297; P = 0.022). Multivariate analysis showed depression score (β = −0.271; P = 0.032) and first rectal sensory threshold volume (β = −0.325; P = 0.013) to be independent predictors of BFT efficacy. CONCLUSION: BFT improves the clinical symptoms of DD patients. Depression state and elevated first rectal sensory threshold volume were independent predictors of poor outcome with BFT.