Irritable Bowel Syndrome-Constipation Clinical Trial
Official title:
Randomized Controlled Trial of Treating Rectal Hypersensitivity - Comparing Escitalopram With Sensory Adaptation Training
Constipation is a common digestive disorder. After excluding dietary factors, drugs and other
secondary causes, at least three broad pathophysiologic subtypes are recognized- dyssynergic
defecation, constipation-predominant irritable bowel syndrome (IBS-C) and slow transit
constipation (STC), all predominantly affect women and elderly. Many patients also
demonstrate abnormal rectal perception with both rectal hyposensitivity and hypersensitivity
being common. Recent surveys show that most constipated patients are dissatisfied with
current therapy. Also, constipated patients showed significant psychological dysfunction and
impaired quality of life. OBJECTIVE: To investigate a novel biofeedback technique of
improving rectal hypersensitivity.
METHODS: A large compliant balloon attached to a barostat was placed in the rectum in 8
patients with rectal hypersensitivity (urgency/pain threshold <30 mm Hg). Sensory
deconditioning was performed by incremental balloon distensions (1-2 mmHg) until normal
thresholds were reached.
To investigate a novel biofeedback technique of improving rectal hypersensitivity using rectal barostat and to compare this with clinical standard of care comprising of low dose antidepressant therapy with escitalopram. Patients will be randomized to sensory adaptation training or escitalopram in a 1:1 ratio ;