Dad Wang has been constipated for many years and finds it very difficult to relieve his bowels every time, although some of the excluded stools are not necessarily very dry. Although he tried many treatments, the results were not satisfactory, and finally had to take laxatives for a long time to relieve the symptoms. The doctor warmly received Father Wang, and after detailed questioning of his condition and rectal and anal canal manometry, he found that the reason for his constipation was that he could not defecate, and he felt strange, why he could not defecate after living for decades. We meticulously communicated and explained the situation we examined to him. Hou Xiaohua, Department of Gastroenterology, Wuhan Union Medical College Hospital
We examined the rectal function of Father Wang and found that, during his defecation, the magnitude of rectal pressure met the normal standard, but at this time the anal sphincter contracted and stool could not be eliminated from the anal opening, which is what we clinically call recto-anal incoordination. If the anus is not relaxed, the stool cannot be eliminated.
We suggested him to adopt the biofeedback treatment method and hoped that he would build up confidence in the treatment process, actively cooperate with the doctor and adhere to the treatment.
Father Wang was brought into a quiet treatment room, and after he calmly laid down on the bed, the doctor patiently explained the treatment process to him: he could directly see the images on the computer monitor. When the doctor inserted a thin catheter with an air bag into his anus, many high and low curves appeared on the monitor. The doctor explained to him that these were the pressure curves of the rectal and anal sphincter muscles that control bowel movements in his body. These pressure curves change as Daddy Wang tightens his anus, simulates defecation, relaxes, and many other actions. In response to the changing curves on the screen, the doctor pointed out which actions were correct and which were incorrect in the process of defecation; he instructed him to contract the rectal muscles and stretch the anal canal muscles in the correct way, so that the original wrong actions could be corrected. The doctor then injected air into the air bag until Dad Wang felt the sensation of defecation, and instructed him to contract and stretch the anal sphincter according to the curve on the display, with the aim of allowing Dad Wang to effectively relax the anal sphincter during defecation. And he was encouraged to do it in the correct way, repeatedly, and asked to gradually transition to the point where he could make the correct movements without looking at the curve. This is biofeedback therapy.
So, what is biofeedback therapy? What are the uses? What diseases can be treated? Under normal circumstances, human beings cannot perceive various physiological activities in the body, such as the digestion of food, smooth muscle contraction, etc. Biofeedback therapy allows patients to observe information about their own physiological activities. In short, biofeedback therapy is a kind of bio-behavioral therapy method, which is to use special equipment to collect information about one’s own physiological activity, process and amplify it, and display it with familiar visual or auditory signals, so that the cerebral cortex can establish feedback links with these organs; to make the patient “know oneself”, and under the condition of knowing oneself Through countless feedback and continuous positive and negative attempts, the patient learns to control physiological activities at will and corrects those that deviate from the normal range, so that the patient can achieve the purpose of “changing oneself”.
Constipation has always been a difficult problem to treat because of its complex causes and stubborn symptoms. Traditional methods, i.e., increasing the body’s intake of fiber and water, are limited; long-term use of contact laxatives can lead to intestinal plexus lesions; and surgical treatment of constipation is both painful and dangerous, with a high recurrence rate. The emergence of biofeedback therapy has undoubtedly opened up new ideas and enriched the treatment of constipation. In the above example, the pressure of the perianal muscles was recorded through a catheter inserted into Daddy Wang’s body and displayed on a computer screen through a computer. Through the screen, Father Wang observed the pressure changes of his anal sphincter during anal contraction and diastole, and learned when it was correct to stretch the anus through the doctor’s guidance and deepened the impression in his mind. Through continuous and repeated training, one learns to control the activity of the anal sphincter at will and improves the strength and coordination of the muscle, thus achieving the purpose of treatment. In addition to treating constipation, biofeedback therapy is also effective for functional fecal incontinence and functional anorectal pain.
Since its invention in the 1970s, biofeedback therapy has attracted great attention in clinical practice with its unique therapy and reliable efficacy, and has been widely used abroad. However, because of its easy tolerance, low treatment cost and outpatient treatment, it has been increasingly recognized and accepted by the majority of gastroenterological factors. It is believed that in the near future, biofeedback therapy will relieve the pain of more and more patients and bring the gospel.
At present, only the Department of Gastroenterology of Wuhan Union Hospital can carry out this program in Hubei.