Biofeedback, a solution for chronic constipation due to anismus

Anismus occurs when the muscles responsible for evacuating stool are out of synch. For this reason it is also called pelvic floor dyssynergia or dyssynergic constipation, where the word “dyssynergia” refers to disturbances of muscle coordination.

Usually, when we have a bowel movement, our abdominal muscles contract to expel fecal matter, while the pelvic floor and sphincter relax to let it pass. It is a process almost as natural as breathing or swallowing.

In people suffering from dyssynergic constipation, the muscles do the opposite of what the brain tells them. The abdominal muscles fail to push sufficiently and the sphincter contracts. Sometimes, despite a good push of the abdomen, the sphincter can remain stubbornly closed.

Anismus affects about 40% of people with chronic constipation,[4] but it is not easy to detect this poor muscle coordination on your own. It must be diagnosed by a gastroenterologist through an examination of the rectum. An anorectal manometry measures changes in pressure in the anal sphincter, and a balloon expulsion test measures the time it takes for a patient to expel an air or fluid-filled balloon from the rectum.[5]

Biofeedback is a method of retraining that involves placing sensors on certain parts of the body, in order to measure physiological reactions in real time and help the patient control or correct certain involuntary processes that cause discomfort. A professional guides the patient through the procedure, explaining what the measurements mean and how to use them to achieve the desired results.

This technique, which helps reduce both physical and psychological stress, is used to treat a number of conditions, such as migraines, tension headaches, urinary incontinence and chronic pain.

In the case of anismus, the goal of biofeedback is to improve the coordination of the muscles in the abdomen, rectum, pelvic floor and anus that are involved in bowel movements. Using a rectal probe connected to a monitor, patients can visualize their muscles contracting and relaxing. They can then gain a better awareness of their efforts and learn how to control them.

During the retraining sessions and with the advice of a professional, the patient learns to master the efforts required to perfectly synchronize their muscles and correct the dyssynergy. Following the recommended four to six sessions,[6] patients should be able to control their muscles without using a device and return to normal bowel movements.

If you suffer from chronic constipation, you should first consult a general practitioner or gastroenterologist, to diagnose the problem and see if anorectal biofeedback is recommended in your case.

This treatment, which requires the use of measuring instruments, is usually administered in a hospital or private clinic by a physiotherapist, physician, nurse or specialized technician. Biron does not offer this type of treatment.

However, new home-based solutions are currently being tested in the United States, with a success rate similar to that of a professionally administered treatment.[7] This device could provide real relief to many people who lack access to biofeedback treatment in a clinic, or for whom this treatment is a source of embarrassment.

Despite its drawbacks, biofeedback can be a useful treatment option when medications and dietary changes fail to correct constipation caused by poor coordination of the rectal and sphincter muscles.

We provide services that can help your doctor diagnose disorders of the digestive system and determine the right treatment.

• Microbiological stool analysis by PCR to facilitate the diagnosis of gastrointestinal infections
• Thyroid profile to detect most abnormalities affecting the thyroid or the secretion of TSH by the pituitary gland
• Immunochemical test for blood in stool to aid in detecting colon cancer
• Fecal calprotectin analysis to screen for chronic inflammatory bowel diseases
• Digestive radiology to capture dynamic images of the organs of the digestive system and observe digestive function.
• Measurement of blood glucose levels (glycemia), especially for diagnosing and monitoring diabetes and hypoglycemia.

Do you have a medical prescription for one of these tests? Please book an appointment online or contact Biron Health Group’s customer service at 1 833 590-2712.