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| 1 | Biofeedback therapy for dyssynergic defecation显示文摘Dyssynergic defecation is one of the most common forms of functional constipation both in children and adults; it is defined by incomplete evacuation of fecal material from the rectum due to paradoxical contraction or failure to relax pelvic floor muscles when straining to defecate. This is believed to be a behavioral disorder because there are no associated morphological or neurological abnormalities, and consequently biofeedback training has been recommended for treatment. Biofeedback involves the use of pressure measurements or averaged electromyographic activity within the anal canal to teach patients how to relax pelvic floor muscles when straining to defecate. This is often combined with teaching the patient more appropriate techniques for straining (increasing intra-abdominal pressure) and having the patient practice defecating a water filled balloon. In adults, randomized controlled trials show that this form of biofeedback is more effective than laxatives, general muscle relaxation exercises (described as sham biofeedback), and drugs to relax skeletal muscles. Moreover, its effectiveness is specific to patients who have dyssynergic defecation and not slow transit constipation. However, in children, no clear superiority for biofeedback compared to laxatives has been demonstrated. Based on three randomized controlled studies in the last two years, biofeedback appears to be the preferred treatment for dyssynergic defecation in adults. | Giuseppe Chiarioni Steve Heymen William E Whitehead | 2006 | World Journal of Gastroenterology2006，12，44： | 44 |
| 2 | Chronic proctalgia and chronic pelvic pain syndromes:New etiologic insights and treatment options显示文摘This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs:chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing:A recently published large randomized,controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle-a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders. | Giuseppe Chiarioni Corrado Asteria William E Whitehead | 2011 | World Journal of Gastroenterology2011，17，40： | 11 |
| 3 | Bloating and functional gastro-intestinal disorders: Where are we and where are we going?显示文摘Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients. This symptom has been described with various definitions, such as sensation of a distended abdomen or an abdominal tension or even excessive gas in the abdomen, although bloating should probably be defined as the feeling(e.g. a subjective sensation) of increased pressure within the abdomen. It is usually associated with functional gastrointestinal disorders, like irritable bowel syndrome, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome Ⅲ criteria named functional bloating. In terms of diagnosis, major difficulties are due to the lack of measurable parameters to assess and grade this symptom. In addition, it is still unclear to what extent the individual patient complaint of subjective bloating correlates with the objective evidence of abdominal distension. In fact, despite its clinical, social and economic relevance, bloating lacks a clear pathophysiology explanation, and an effective management endorsement, turning this common symptom into a true challenge for both patients and clinicians. Different theories on bloating etiology call into questions an increased luminal contents(gas, stools, liquid or fat) and/or an impaired abdominal empting and/or an altered intra-abdominal volume displacement(abdomino-phrenic theory) and/or an increased perception of intestinal stimuli with a subsequent use of empirical treatments(diet modifications, antibiotics and/or probiotics, prokinetic drugs, antispasmodics, gas reducing agents and tricyclic antidepressants). In this review, our aim was to review the latest knowledge on bloating physiopathology and therapeutic options trying to shed lights on those processes where a clinician could intervene to modify disease course. | Paola Iovino Cristina Bucci Fabrizio Tremolaterra Antonella Santonicola Giuseppe Chiarioni | 2014 | World Journal of Gastroenterology2014，20，39： | 9 |
| 4 | Bio-feedback treatment of fecal incontinence: Where are we, and where are we going?显示文摘Fecal incontinence is a disabling disease, often observed in young subjects, that may have devastating psycho-social consequences. In the last years, numerous evidences have been reported on the efficacy of bio-feedback techniques for the treatment of this disorder. Overall, the literature data claim a success rate in more than 70% of cases in the short term. However, recent controlled trials have not confirmed this optimistic view, thus emphasizing the role of standard care. Nonetheless, many authors believe that this should be the first therapeutic approach for fecal incontinence due to the efficacy, lack of side-effects,and scarce invasiveness. Well-designed randomized,controlled trial are eagerly awaited to solve this therapeutic dilemma. | Giuseppe Chiarioni Barbara Ferri Antonio Morelli Guido Iantorno Gabrio Bassotti | 2005 | World Journal of Gastroenterology2005，11，31： | 5 |
| 5 | 生理反馈只对排便功能失常患者有利,而对独立性慢传输型便秘患者无效 | Chiarioni G. Salandini L. Whitehead W.E. 王志宇 | 2005 | 世界核心医学期刊文摘(胃肠病学分册)2005，0，12： | 4 |
| 6 | Biofeed- back is superior to laxatives for normal transit consti- pation due to pelvic floor dyssynergia显示文摘 | Chiarioni G Whitehead WE Pezza V | 2006 | Gastroenterology2006，130，： | 1 |
| 7 | Anorectal manometric abnormalities and colonic propulsive impairment in patients with severe chronic idiopathic constipation 显示文摘 | BASSOTrI G CHIARIONI G VANTINI I | 1994 | Digestive Diseases & Sciences1994，39，7： | 1 |
| 8 | Biofeedback benefits only patients with outlet dysfunction, not pa- tients with isolated slow transit constipation显示文摘 | Chiarioni G Salandini L Whitehead WE | 2005 | Gas- troenterolgy2005，129，： | 1 |
| 9 | Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia显示文摘 | Chiarioni G Whitehead WE Pezza V | 2006 | Gastroenterology2006，130，3： | 1 |
| 10 | Biofeedback benefits only patients with outlet dysfunction,not patient with isolated slow transit constipation显示文摘 | Chiarioni G Salandini L Whitehead WE | 2005 | Gastroenterology2005，129，1： | 1 |
| 11 | Biofeedback is superior toelectrogalvanic stimulation and massage for treatment of levator anisyndrome显示文摘 | Chiarioni Ci Nardo A Vantini I | 2010 | Gastroenterology2010，138，4： | 1 |
| 12 | Sensory retraining is key to biofeedback therapy for formed stool fecal incontinence显示文摘 | G Chiarioni G Bassotti Samuela Stegagnini I Vantini W.E Whitehead | 2002 | The American Journal of Gastroenterology2002，，1： | 1 |
| 13 | Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia 显示文摘 | Chiarioni G Whitehead W E Pezza V | 2006 | Gastroenterology2006，130，3： | 1 |
| 14 | Anorectal manometric abnormalities and colonic propulsive impairment in patients with severe chronic idiopathic constipation显示文摘 | BASSOTTI G CHIARIONI G VANTINI I | 1994 | Dig Dis Sci1994，39，7： | 1 |
| 15 | The role of biofeedback in the treatment of gastrointestinal disorders 显示文摘 | Chiarioni G Whitehead WE | 2008 | Nat Clin Pract Gastroenterol Hepatol2008，5，7： | 1 |
| 16 | Sensory retraining is key to biofeedback therapy for formed stool fecal incontinence显示文摘 | CHIARIONI G BASSOTTI G STANGANINI S | 2002 | Am J Gastroenterol2002，97，1： | 1 |
| 17 | Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation显示文摘 | Chiarioni G Salandini L Whitehead WE | 2005 | Gastroenterology2005，129，1： | 1 |
| 18 | Biofeedback is surperior to laxatives for normal transit constipatioin due to pelvic floor dyssynergia显示文摘 | Chiarioni G Whitehead W E Pezza V | 2006 | Gastroenterology2006，130，3： | 1 |
| 19 | Biofeedback benefits only patients with outlet dysfunction, not patients with isolated slow transit constipation显示文摘 | Chiarioni G | 2005 | Gastroenterology2005，129，1： | 1 |
| 20 | Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia显示文摘 | Chiarioni G | 2006 | Gastroenterology2006，130，3： | 1 |
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