Constipation Clinical Trial
Official title:
Mechanism of Action of Biofeedback Therapy
Biofeedback therapy improves bowel symptoms and anorectal function in patients with
dyssynergic defecation, however its mechanism of action is not known. The investigators
hypothesize that biofeedback therapy enhances gut-brain-gut communication by altering
cortical processing of information and improving cortically mediated neuromuscular function
of the gut. The investigators' specific aims are; (1) To evaluate the afferent cortical
evoked potentials in response to the electrical stimulation of the anorectum (i) before and
after biofeedback therapy and (ii) compare responders with nonresponders. (2) To evaluate the
corticofugal tracts (efferent) by recording the anal and rectal electromyographic responses
following noninvasive lumbosacral and transcranial magnetic stimulation (i) before and after
biofeedback therapy and (ii) compare responders with nonresponders.
The investigators hypothesize that biofeedback therapy enhances gut-brain-gut communication
and alters cortical and neuromuscular function. The investigators' specific aims are to
evaluate 60 patients with dyssynergia (i) before and after biofeedback therapy and (ii)
compare responders with nonresponders by examining:
(A) The afferent cortical evoked potentials using electrical stimulation of the anus and
rectum.
(B) The efferent cortical evoked potentials by lumbosacral and transcranial magnetic
stimulation and recording the anal and rectal electromyographic responses.
n/a
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