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Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed t...

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Autores principales: Forootan, Mojgan, Shekarchizadeh, Masood, Farmanara, Hamedreza, Esfahani, Ahmad Reza Shekarchizadeh, Esfahani, Mansooreh Shekarchizadeh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PAGEPress Publications, Pavia, Italy 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895989/
https://www.ncbi.nlm.nih.gov/pubmed/29686820
http://dx.doi.org/10.4081/ejtm.2018.7327
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author Forootan, Mojgan
Shekarchizadeh, Masood
Farmanara, Hamedreza
Esfahani, Ahmad Reza Shekarchizadeh
Esfahani, Mansooreh Shekarchizadeh
author_facet Forootan, Mojgan
Shekarchizadeh, Masood
Farmanara, Hamedreza
Esfahani, Ahmad Reza Shekarchizadeh
Esfahani, Mansooreh Shekarchizadeh
author_sort Forootan, Mojgan
collection PubMed
description Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9 ± 45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50 ±0.71 versus 1.33±- 0.71 before and 1.30 ± 0.95 versus 0.67 ±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.
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spelling pubmed-58959892018-04-23 Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome Forootan, Mojgan Shekarchizadeh, Masood Farmanara, Hamedreza Esfahani, Ahmad Reza Shekarchizadeh Esfahani, Mansooreh Shekarchizadeh Eur J Transl Myol Article Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9 ± 45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50 ±0.71 versus 1.33±- 0.71 before and 1.30 ± 0.95 versus 0.67 ±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy. PAGEPress Publications, Pavia, Italy 2018-03-06 /pmc/articles/PMC5895989/ /pubmed/29686820 http://dx.doi.org/10.4081/ejtm.2018.7327 Text en http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License (by-nc 4.0) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Article
Forootan, Mojgan
Shekarchizadeh, Masood
Farmanara, Hamedreza
Esfahani, Ahmad Reza Shekarchizadeh
Esfahani, Mansooreh Shekarchizadeh
Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome
title Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome
title_full Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome
title_fullStr Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome
title_full_unstemmed Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome
title_short Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome
title_sort biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895989/
https://www.ncbi.nlm.nih.gov/pubmed/29686820
http://dx.doi.org/10.4081/ejtm.2018.7327
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