Part 1: Biofeedback Therapy for Chronic Childhood Constipation

Published on Aug 13, 2021

Trailblazing Clinician Cites Far-Ranging Benefits

It can lead to ongoing ER visits, anxiety and depression. In many cases, it disrupts schooling and can significantly impact a patient’s future. Often, it starts with a small incident and quickly spirals out of control. Chronic childhood constipation is much more than just an annoyance. As medical professionals, we know it can have a chronic impact on quality of life of patients and their entire families.

Mary Alice Dombrowski, APRN-CFNP, DNP, University Hospitals Cleveland Medical Center Rainbow Babies & Children’s Hospital, has specialized in treating childhood constipation and related GI disorders for more than a decade. She knows firsthand the havoc it can wreak on the lives of patients and their families. She also knows the benefits appropriate diagnosis and intervention, particularly biofeedback, can have for many youngsters.

Just what causes chronic childhood constipation? Not surprisingly, the single most frequent question parents ask Ms. Dombrowski is just that: “Why is this happening to my child?” There is no single answer. However, most often, chronic constipation occurs because at some point children have withheld their stool for a variety of reasons, whether fear of an unfamiliar restroom, illness, distraction or a diet that makes defecation difficult. Eventually, passing stool becomes painful, which leads to a vicious cycle of increasing fear, painful pushing, ongoing stool build-up in the colon, rectal and colonic distension and dysmotility . . . and even more frustration.

The end result is often dyssynergistic defecation and fecal seepage. Just as the cause of chronic constipation is not the same for each child, the specific problems interfering with defecation are not either. Biofeedback helps her pinpoint the difficulty and address it through her therapy.

“When the problem lasts weeks, months and years and fecal soiling is involved, biofeedback therapy can make a dramatic difference,” she notes. “The Medspira mcompass® biofeedback system works hand in hand with the company’s anorectal manometry device and has been extremely effective in helping young patients understand and coordinate the muscles involved in defecation, putting them quickly and effectively on the road to recovery.”

Ms. Dombrowski typically delivers four to five biofeedback sessions that are two weeks to a month apart with home practice in between. When patients and their families are motivated and follow through, they often see significant improvement during this relatively brief time period. For kids who are frequently sent home from school and cannot take part in typical childhood activities due to fecal soiling, this therapy can be enormously valuable. When the problem clears up, confidence increases, and patients feel more comfortable with school, joining sports teams and clubs and even having sleepovers.

“It can help turn their life around,” she says.

Our exploration of the benefits of biofeedback therapy for chronic childhood constipation with Mary Alice Dombrowski, APRN-CFNP, DNP, continues in our upcoming blog. Look for it soon.

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