What's in a name? Putting patients first: biofeedback for irritable bowel syndrome patients with dyssynergic defecation.

摘要

On the basis of pathophysiology and symptom patterns, constipated patients are usually categorized into those with constipation-predominant irritable bowel syndrome, slow transit constipation (STC), and dyssynergic defecation,1 but most clinicians and researchers agree that there is a significant overlap among these subtypes.With regards to treatment, several randomized controlled trials have previously shown that biofeedback therapy is effective, both in the short and long-term management of patients with dyssynergic defecation.About two-thirds of patients with dyssynergic defecation have coexisting STC; in this group, biofeedback treatment not only improves bowel symptoms and dyssynergia but also colonic transit, most likely by improving the outlet dysfunction.1"3 In contrast, patients with STC alone will not respond to biofeedback therapy.6 Now, whether dyssynergics with coexisting constipation-predominant irritable bowel syndrome respond to biofeedback therapy has not been investigated earlier, and is the topic of the study by Patcharatrakul and Gonlachanvit.