Research Database –
International Updates

Colon Health

Issue 90

SUNIC and co-workers, Children’s Hospital Zagreb, Zagreb, Croatia, evaluated the efficacy of biofeedback therapy for chronic constipation in children.
Background: Chronic constipation is a common disorder in childhood, but nothing is known about the underlying mechanisms. Conventional methods of treatment often fail. It has been suggested that biofeedback may be an effective treatment, but the results in the literature are variable. Here biofeedback has been compared to conventional treatment.
Methods: 49 children aged around 8 with idiopathic chronic constipation were recruited. 24 were allocated to conventional therapy, and 25 to biofeedback therapy. Treatment was carried out for three months. Data on colonic function and detailed histories of bowel function and symptoms were collected before and after treatment.
Results: After 3 months of treatment, the biofeedback group showed significantly improved bowel function as compared to the control group on conventional treatment.
Conclusions: Biofeedback is an effective treatment for chronic constipation in children in the short term.
Sunic OM, Mihanovic M, Bilic A, Jurcic D, Restek-Petrovic B, Maric N, Dujsin M, Bilic A. Efficiency of biofeedback therapy for chronic constipation in children. Collegium antropologicum 26 Suppl: 93-101, Dec 2002.

Issue 77

FARHADI and colleagues, Department of Internal Medicine (Division of Digestive Disease), Pharmacology, Molecular Biophysics and Physiology, Rush University Medical Center, Chicago, IL, USA, reviewed (126 references) the current options available for treating irritable bowel syndrome (IBS).
Background: IBS is common, with between 10 and 25% of the population suffering symptoms, it is the most common gastrointestinal condition presented to doctors. In addition to painful symptoms, sufferers often have to contend with medical expenses, and negative impacts on their social and working lives. The causes of IBS can arise anywhere between the gut itself and the areas of the brain that control its function, and may be due primarily to psychological/emotional factors/stress, an abnormality of the muscular reflexes in the gut that influence bowel movements, or increased sensation/sensitivity in the gut. IBS is diagnosed using a set of established criteria – either the Manning or Rome-II criteria.
Discussion: Treatment tends to have greater success if the sufferer understands the causes of his/her particular condition and is given reassurance that it can be addressed. Currently, the main approaches to treatment include a combination of: stress management; diet modification, including increased dietary fibre; and medication. Drug treatments mainly address symptoms, although some newer agents can address gut motility problems or reduce gut sensation in some cases. Psychoactive drugs (e.g. sedatives, antidepressants, antipsychotics) may be helpful in cases where an individual also suffers from a mental health problem (e.g. depression, generalized anxiety), as the symptoms of IBS may be related or worsened by this accompanying condition. Many patients who are dissatisfied with orthodox treatment options and/or continue to experience troublesome symptoms turn to complementary/alternative therapies including: homeopathy, acupuncture, special diets, herbal medicine, hypnotherapy and other psychological treatments. Accordingly, doctors are increasingly offering such therapies as treatment options, either alone, or as adjuncts to the usual treatment approach, to patients whose symptoms persist despite an initial programme of conventional therapy.
Farhadi A et al. Irritable bowel syndrome: an update on therapeutic modalities. Expert Opinion on Investigational Drugs 10 (7): 1211-22. Jul 2001.