The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Biofeedback: Constipation and fecal incontinence

     Researchers from the University Hospital, in Tübingen, Germany, reviewed the evidence.

    First, the details.

    • For constipation, 8 studies were identified.
    • For fecal incontinence, 11 trials were identified.
    • The data were pooled and a meta-analysis conducted.

    And, the results.
    Constipation

    • Biofeedback training was significantly better than non-biofeedback (laxatives, placebo, sham training, and botox injection).
    • Biofeedback was as effective as electromyographic biofeedback.

    Fecal incontinence

    • Biofeedback was as effective as non-biofeedback therapy.
    • There were no differences among various modes of biofeedback.

    The bottom line?
    The authors commented that the studies were flawed, with variable endpoints and a lack of quality.

    Despite this, they concluded, “Biofeedback training for pelvic floor dyssynergia [aka anismus: failure of pelvic floor muscles to relax, or a paradoxical contraction of these muscles, with defecation] shows substantial specific therapeutic effect.”

    By comparison, “Biofeedback training for incontinence is still lacking evidence for efficacy.”

    “In both conditions, biofeedback seems to play a minor role.”

    More positive reports on biofeedback and fecal incontinence are here and here.

    7/2/09 18:13 JR

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