Biofeedback Therapy Versus Botox Injection in Treatment of Dyssynergic Defecation.

Biofeedback Versus Botox Injection in Treatment of Dyssynergic Defecation (Randomized Controlled Trial)

assessment the Improvement symptoms of obstructed defecation after biofeedback training versus botulinum toxin injection

This is a randomized controlled trial including 78 patients diagnosed with obstructed defecation syndrome confirmed by detailed history talking, full clinical examination, anorectal manometry and defecography.

Included patients divided into two equal groups: first group ( biofeedback therapy group) patients recieved biofeedback therapy for six sessions over one month, the second group:( botulinum toxin group) received botulinum toxin injection 100 IU in buborectalis muscle.

The primary outcome is improvement of symptoms after one year

Inclusion Criteria:

• patients of both genders
• age of 18 years or older
• fulfillment of the Rome 3 constipation criteria for the past 3 months, symptom onset as a maximum six months prior to diagnosis, patients suffer from prolonged, incomplete and challenging evacuation

Exclusion Criteria:

• Anismus cases with secondary reason for constipation
• patients who undergone anorectal surgery Patients with colonic inertia
• conditions that make biofeedback training impossible
• cases with primary illness causing constipation as hypothyroidism