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Systematic review and meta-analysis
Poor quality evidence to support the use of biofeedback for the treatment of functional constipation in adults
  1. Arnold Wald
  1. Department of Gastroenterology and Hepatology, University of Wisconsin, Madison, Wisconsin, USA
  1. Correspondence to : Professor Arnold Wald, Department of Gastroenterology and Hepatology, University of Wisconsin Medical Foundation Centennial Building, 1685 Highland Ave, Madison, WI 53705-2281, USA; axw{at}

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Commentary on:

Implications for practice and research

  • Currently, there is insufficient evidence to make conclusions regarding the efficacy and safety of biofeedback for patients with chronic constipation.

  • Further, well-designed randomised controlled trials are needed to allow definitive conclusions to be drawn.


Most patients with chronic constipation respond to conservative and pharmacological treatments. However, a minority of patients are refractory to treatment, one of the reasons being abnormalities of defaecation characterised by inability to relax the striated muscles which facilitate defaecation and/or ineffective defaecatory propulsive forces. Biofeedback, which employs instrumental learning through visual or auditory feedback using anorectal manometry or electromyography, has been recommended to improve muscle coordination in selected patients …

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  • Competing interests None.