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Completed

NCT Number: NCT00982839

Rectal Sensory Training - A Study of Two Techniques

At least 60% of patients with constipation and dyssynergic defecation (anismus) and between 30-50% of patients with fecal incontinence exhibit impaired rectal sensation. The problem may be improved by biofeedback therapy. Traditionally, biofeedback therapy was performed by using a syringe-assisted technique. Although some respond to this method, many, particularly those with severe rectal hyposensitivity have proved to be refractory. Also, repeated inflation and deflation of a large volume of air, using a hand-held syringe is cumbersome and time consuming. Recently, in pilot observations, the investigators have seen that a barostat-assisted technique of biofeedback therapy was simpler and easier to perform and could possibly be more effective. The investigators' aims are:

1. To perform a randomized controlled study that compares the syringe-assisted sensory conditioning (biofeedback therapy) technique with the barostat assisted sensory conditioning for improving the rectal sensation in patients with rectal hyposensitivity and bowel dysfunction. 2. To investigate the impact of sensory conditioning on psychosocial issues and quality of life. 3. To compare the cost-effectiveness of each therapeutic modality The specific hypotheses that will be tested are;

When compared to those who receive syringe-assisted training, patients receiving barostat training will demonstrate:

1. Lower sensory thresholds for rectal perception (first sensation, desire to defecate and urgency) 2. Greater satisfaction with bowel function (VAS Score), stool frequency,consistency & straining. 3. Better learning ability and greater ease of administering this training.

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Key information

Conditions

Rectal Hyposensitivity Constipation Pathological Conditions, Signs and Symptoms Signs and Symptoms Signs and Symptoms, Digestive

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

University of Iowa Hospitals and Clinics

Iowa City, Iowa, 52242, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients categorized as having dyssynergic defecation or slow transit constipation or normal transit constipation will be eligible.
  • All patients must demonstrate rectal hyposensitivity during a manometry with values that are outside 2 S.D. of normal range and demonstrate any two of the following: a) Threshold for 1st sensation > 40 cc. b) Threshold for desire to defecate > 130 cc. c) Threshold for urgency to defecate >180 cc.

Exclusion criteria

  • Patients taking drugs that are constipating, (e.g.; calcium channel antagonists will either be excluded or drug discontinued).
  • Patients with co-morbid illnesses; severe cardiac disease, chronic renal failure or previous gastrointestinal surgery except cholecystectomy and appendectomy.
  • Neurologic diseases e.g.; head injury, epilepsy, multiple sclerosis, strokes, spinal cord injuries.
  • Impaired cognizance (mini mental score of < 15) and/or legally blind.
  • Pregnant or likely to conceive during the course of the study. Women with potential for pregnancy must be willing to use contraceptive measures during the study. Urinary pregnancy tests will be performed on such women prior to any radiologic procedures.
  • Hirschsprung's disease.
  • Alternating constipation and diarrhea (22).
  • Ulcerative/Crohns colitis.
  • Previous pelvic surgery, rectocele/bladder repair, radical hysterectomy, anal surgery.
  • Rectal prolapse or anal fissure. 11) Patients with severe rectal hyposensitivity, first sensation or desire to defecate > 320 cc

Treatment and study plan

Syringe Conditioning

Procedure

A syringe will be used to inflate the balloon at the end of the probe which is inside of the rectum.

Other names: Syringe

Barostat Conditioning

Procedure

A barostat machine will be used to inflate the balloon at the end of the probe which is inside of the rectum.

Other names: Barostat

Primary outcomes

  1. Rectal Sensory Thresholds

    Time frame: Trial entry and at the end of 3 months

Secondary outcomes

  1. Satisfaction with bowel function based on Visual Analog Scale (VAS)

    Time frame: Trial Entry and at the end of 3 months

Sponsors and collaborators

Lead sponsor

Augusta University

Other

Registry information

Official study title

Rectal Sensory Training - A Randomized Controlled Study of Two Techniques

Important dates

Study start
2004
Primary completion
2014
Study completion
2014
First posted
Sep 23, 2009
Registry last updated
Sep 17, 2014

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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