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Release: Sept. 5, 2000

UI researchers receive $1.26 million NIH grant to study constipation treatment

IOWA CITY, Iowa -- University of Iowa Health Care researchers have received a five-year, $1.26 million grant from the National Institutes of Health to study neuromuscular conditioning therapy, also known as biofeedback, to treat constipation. The grant was effective Sept. 1.

The investigation will be the first large-scale randomized, controlled study to help determine the efficacy and scientific basis of biodfeedback treatment for constipation, said principal investigator Satish S.C. Rao, M.D., Ph.D., UI associate professor of internal medicine. The study also will compare home-based and office-based treatments and assess the quality of life and psychosocial function of patients.

The biofeedback technique that will be used was pioneered in large part at the UI. The technique involves making people more aware of unconscious or involuntary bodily functions involved in defecation and includes the use of a probe as well as visual and verbal feedback techniques so that individuals may relearn the normal process of having a bowel movement.

"Physical rehabilitation treatment has helped hundreds of patients with constipation," Rao said. "However, we don't know if the beneficial effects are due to the actual behavioral changes or to the consequences of a patient receiving medical attention. This study is designed to help answer that question."

Constipation affects more than four million Americans, predominantly women and the elderly. However, the condition is not well understood, and most treatments depend on the use of laxatives and/or changes in diet and exercise.

"Only recently we have learned that the inability to coordinate the muscles involved in defecation may lead to constipation," Rao said. "Additionally, some people with constipation don't sense the arrival of stool in the rectum. We will study whether biofeedback might help these individuals improve sensation so they can use their muscles, which function normally."

Other people can sense the arrival of stool but can't use their muscles properly, Rao said. In their cases, biofeedback might help them learn to use their muscles effectively.

He added that some individuals involved in the study will have a combination of the sensation and muscle problems or different problems altogether that cause constipation. Each individual case requires careful appraisal and treatment.

Physicians whose patients might be interested in participating in the study can call Rao or Joan Kempf, study coordinator, at (319) 384-9756

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.