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ABSTRACT: The aim of this prospective quasi-experimental study was to explore the influence of biofeedback training on patients with functional constipation (FC). Changes in clinical symptoms, psychological status, quality of life, and autonomic nervous function in 21 FC patients before and after biofeedback training were investigated. The psychological status and quality of life were evaluated with the Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), and a Chinese version of the MOS 36-Item Short-Form Health Survey. Autonomic nervous function was assessed on the basis of heart rate variability recorded with a HANS-1000 autonomic nervous biofeedback apparatus. After a complete course of training (10 sessions), clinical symptoms were greatly improved (p < .01), and the SAS and SDS scores were markedly decreased. There was a significant difference in the SAS and SDS scores before and after biofeedback (p < .01). The scores of general health perceptions, physical functioning, emotional role functioning, bodily pain, and vitality were increased significantly (p < .05), especially the scores of general health perceptions and emotional role functioning (p < .01), which indicated that quality of life in FC patients was significantly improved. No marked improvement of autonomic nervous function was found. Although a slight improvement in autonomic nervous activity was found, there was no significant statistical findings (p > .05). We conclude that biofeedback training can improve clinical symptoms, psychological status, and quality of life in FC patients, but further research is needed to determine whether biofeedback training can improve the autonomic nervous function in FC patients.
Gastroenterology nursing: the official journal of the Society of Gastroenterology Nurses and Associates 03/2012; 35(2):85-92. · 0.47 Impact Factor
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ABSTRACT: The aim of the study was to evaluate the changes in symptoms and quality of life in people with puborectalis dyssynergia after biofeedback by using Short Form-36 and Patient Assessment of Constipation Quality of Life Questionnaire.
Biofeedback is an effective treatment in clinical symptoms for puborectalis dyssynergia. However, little is known about the degree of the variation in the quality of life for these people after biofeedback.
Thirty-six people with puborectalis dyssynergia were studied between June 2006 and March 2008. A bowel symptom record, a generic quality of life measure - the Short Form-36 and a disease-specific measure - the Patient Assessment of Constipation Quality of Life Questionnaire were recorded before and after biofeedback.
Thirty-one people rated their satisfaction with behavioural treatment as 'major' or 'fair' and substantial symptom improvements occurred. Before treatment, seven of Short Form-36 subscales (except bodily pain) were significantly lower in people with puborectalis dyssynergia than those in healthy individuals. Following treatment, all subcategories except general health showed improvement surpassing pretreatment baseline values and equalling those for normal. The total Patient Assessment of Constipation Quality of Life Questionnaire score also dramatically improved as did all subscales. The nurses continually encouraged the participants, increased participants' motivation and got good outcomes.
Patient-centred functional status outcomes measured by general and disease-specific instruments give critical data, from which to inform patient management. The nurses should give psycho-social support and increase the participants' motivation during training.
Journal of Advanced Nursing 02/2011; 67(6):1285-93. · 1.48 Impact Factor
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ABSTRACT: To verify the correlation between anorectal function and psychological conditions of depression/anxiety in patients with functional constipation. The aim of this study is to explore why people with depression/anxiety have higher incidence of functional constipation and recommend innovative interventions to advance patient care of functional constipation.
A prospective correlational design.
Anorectal manometry was performed on functional constipation patients (n=70) through the Medtronic Synectics PC Polygraf, while the psychological condition was tested by Self-Rating Anxiety Scale and Self-Rating Depression Scale. Twenty normal controls were also studied.
Compared with controls, (1) functional constipation patients displayed higher squeezing pressure, defaecation thresholds and maximal volume of tolerance (p<0·01), and there was no significant difference in anorectal resting pressure, defaecating pressure, minimum relaxation volume and first sensation (p>0·05). (2) Functional constipation patients showed higher depression/anxiety scores (p<0·01). (3) The anorectal squeezing pressure was negatively correlated with anxiety and depression scores, while the first sensation and maximal volume of tolerance was positively correlated with depression score (p<0·05).
Abnormal anorectal function correlates to depression/anxiety levels indicating that depression/anxiety may contributes to functional constipation. The possible pathology is via brain-gut axis.
The study indicates that nurses should pay attention to the patients' psychological needs, especially to those interested in seeing the physician and doing unnecessary examinations repeatedly to find any organic disease. Integrated nursing intervention should be applied to improve patients' psychological adaptation and boost the functional constipation therapeutic effect.
Journal of Clinical Nursing 07/2010; 19(13-14):1838-43. · 1.12 Impact Factor
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ABSTRACT: To explore the effects of biofeedback training on clinical symptom, psychological state and quality of life in patients with functional constipation (FC).
Forty-nine patients with FC diagnosed by Rome III were enrolled and received biofeedback training. Bowel symptom measure, Zung's self-rating anxiety scale (SAS), self-rating depression scale (SDS) and Chinese version of the MOS 36-item short form healthy survey (SF-36) were recorded to assess the effects before and after treatment.
After biofeedback training, clinical symptom of patients with FC was greatly improved: there was a very significant decrease in total and subscales scores of bowel symptom including spontaneous frequency of bowel movements, straining effort, sensation of anorectal obstruction/blockage, stool consistency and bloating. Patients with FC also improved their quality of life as well as psychological status after biofeedback. All subcategories of SF-36 including general health, physical function, bodily pain, role physical, vitality, social function, role emotion and mental health showed marked increase. Compared to the scores before biofeedback training, SAS (41.0±8.1 vs 46.5±11.9) and SDS (44.0±8.2 vs 51.2±11.5) scores decreased significantly after biofeedback training.
Biofeedback training can improve clinical symptom, psychological status and quality of life in patients with FC.
Zhonghua nei ke za zhi [Chinese journal of internal medicine] 07/2010; 49(7):591-4.
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ABSTRACT: Irritable bowel syndrome (IBS) is a functional bowel disorder which is characterized by abdominal pain and disturbed bowel habits. The pathophysiological mechanism is complex and still remains incompletely clear. Alterations at both the central and the peripheral level are thought to contribute to the symptoms of IBS, including psychosocial factors, visceral hypersensitivity and abnormal gastrointestinal motility and secretion. Several gut peptides contribute to the regulation of gastrointestinal function, but little is known about gut hormone secretion in IBS.
We evaluated the concentrations of cholecystokinin (CCK), vasoactive intestinal peptide (VIP), somatostatin, substance P, neuropeptide Y (NPY) in plasma and in sigmoid tissue in 40 patients with IBS and 15 age- and gender-matched controls by using radioimmunoassay.
IBS patients had higher plasma level of CCK (p < 0.01), and the level of CCK in the sigmoid was also increased compared with controls (p < 0.05). The levels of somatostatin and substance P in fasting plasma and in the sigmoid were not different between IBS patients and control subjects (p > 0.05), but the levels of VIP in sigmoid tissue or in plasma were higher in IBS patients than in control group (p < 0.01). The NPY levels in both plasma and the sigmoid were significantly lower in IBS patients than in controls (p < 0.05). Plasma NPY level in patients with IBS with diarrhea as a predominant bowel pattern was lower than in patients with IBS with constipation as a predominant bowel pattern.
IBS patients have increased levels of CCK and VIP and decreased NPY levels in fasting plasma and sigmoid tissue. These alterations of VIP, CCK and NPY may play a role in the pathogenesis of IBS.
Digestion 10/2008; 78(2-3):72-6. · 2.05 Impact Factor
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ABSTRACT: To investigate the effect of erythromycin on the contractive activity of the isolated gastric antrum smooth muscle and somatostatin (SS), vasoactive intestinal peptide (VIP), motilin (MTL), and substance P (SP) in plasma and isolated gastric antrum tissue of diabetes mellitus (DM) rat models.
Thirty male Sprague-Dawley rats were divided into three groups: control group (n = 10), DM group (n = 10), and erythromycin group (DM models with erythromycin treatment, n = 10). A single dose of streptozotocin (100 mg/kg, dissolved in 0.1 mol/L citric acid buffer, pH4.5) was injected intraperitoneally. After 48 to 72 hours, rats with blood glucose above 16.7 mmol/L and urine glucose level to be (+++) to (++++) over one week were considered successful DM models. The resting tension, mean contractile amplitude and frequency of spontaneous change in isolated longitudinal and circular gastric antrum smooth muscle strips were measured. SS, VIP, MTL, and SP levels in plasma and gastric antrum tissue were measured using radioimmunoassay.
(1) In the isolated gastric antrum smooth muscle strips, the gastric motility parameters were lower in DM group than those in control group except circular smooth muscle contractile amplitude and longitudinal smooth muscle contractile frequency. The gastric motility parameters were significantly strengthened in erythromycin group, compared with DM group except longitudinal smooth muscle resting tension (P < 0.01). (2) Plasma SS, VIP, and MTL concentrations in DM group were higher than those in control (P < 0.05), while the SP level decreased (P < 0.05). In the gastric antrum, SS of DM group was significantly higher than that of control group (P < 0.01), while SP and MTL levels were lower than those of control group (P < 0.05 and P < 0.01, respectively). However, the level of VIP in gastric antrum tissue did not change among three groups. The plasma level of SS in erythromycin group was higher than that of DM group (P < 0.05). (3) The blood glucose was lower in erythromycin group than DM group (P < 0.01).
Erythromycin has direct effects on contractive activity of gastric smooth muscle in diabetic rats, but there are few effects on neuroendocrine peptides. Gastric-motility disorders in diabetic rats have a correlation with the changes of neuroendocrine peptide levels in plasma and gastric antrum tissue.
Chinese Medical Sciences Journal 10/2005; 20(3):176-80.
