Biofeedback treatment for chronic constipation and encopresis in childhood: long-term outcome.

Abstract

Abnormal defecation dynamics often are present in children with chronic constipation and encopresis. Patients who learned normal defecation dynamics with biofeedback treatment had improved short-term outcome. The aim of our research was to evaluate if biofeedback treatment improved long-term outcome. One hundred twenty-nine children with constipation, encopresis, and abnormal defecation dynamics were treated conventionally; 63 of them received additional biofeedback training directed towards teaching normal defecation dynamics. At follow-up (4.1 +/- 1.5 years), 86% of conventionally treated patients and 87% of biofeedback-treated patients had improvement in encopresis; 62% of conventionally treated patients, 50% of successful biofeedback-treated patients, and 23% of unsuccessful biofeedback-treated patients had recovered from chronic constipation and encopresis. Recovery rates were similar for conventionally treated patients and biofeedback-treated patients who learned normal defecation dynamics (P > .2) but significantly lower for unsuccessful biofeedback-treated patients (P < .02). Length of follow-up was significantly related to recovery (P < .01). Learning normal defecation dynamics with biofeedback training did not increase long-term recovery rates in children with chronic constipation, encopresis, and abnormal defecation dynamics above those achieved with conventional treatment alone.