Constipation Clinical Trial
Official title:
Effect of Treatment of Constipation on Dyspeptic Symptoms in Patients With Constipation and Functional Dyspepsia
Background. Functional dyspepsia is characterized by symptoms that apparently originate in
the stomach without detectable cause by conventional diagnosis test. The pathophysiology of
functional dyspepsia is not known, but a number of data indicate that dyspeptic patients have
increased sensitivity of the digestive system, so that physiological stimuli may induce their
symptoms. Some patients with functional dyspepsia have also functional constipation and the
investigators hypothesize that in them constipation triggers or facilitates dyspeptic
symptoms, and consequently, correction of constipation relieves dyspeptic symptoms.
Objective. To demonstrate the superiority of biofeedback versus a fiber supplement for the
treatment of dyspeptic symptoms in patients with constipation due to functional outlet
obstruction.
Design. Randomized, controlled parallel trial performed in a referral center. Participants.
Consecutive patients complaining of symptoms of functional dyspepsia and functional outlet
obstruction.
Interventions: Patients will be assigned to experimental (biofeedback for functional outlet
obstruction) and active comparator (fiber supplementation) arms. Biofeedback for functional
outlet obstruction: sessions of biofeedback guided by anorectal manometry (performed during
the first 3 weeks of the intervention period) combined with instructions for daily exercising
for 4 weeks. Fiber supplementation: 2.5 g plantago ovata per day for 4 weeks. Main outcome
and measures. Clinical symptoms of functional dyspepsia measured by daily questionnaires for
7 consecutive days before and during the last week of intervention.
Relevance. Functional Dyspepsia, defined by purely clinical criteria, brings together a
diverse group of conditions with different pathophysiology. As a result, the treatment is
empirical and globally inefficient. This study will identify a subset of patients with a
common pathophysiological mechanism of dyspeptic symptoms (functional outlet obstruction)
which respond to specific treatment (biofeedback).
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