Biofeedback therapy for chronic constipation in a patient with Prader-Willi syndrome

Juan E. Corral, Rahul Kataria, Dawn Vickers, Raghad Koutouby, Baharak Moshiree

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Constipation is a common feature of Prader-Willi syndrome. Research exploring the prevalence, cause and treatment options for constipation is limited and lacks objective measurements such as anorectal manometry. We report a case of a 16-year-old lady with Prader-Willi syndrome presenting with rectal pain and constipation for 2 years despite multiple medications and weekly enemas. She also noted passive fecal incontinence that required frequent manual disimpactions. Anorectal manometry revealed an abnormal relaxation of the puborectalis and external sphincter muscles on push maneuvers suggesting dyssynergic defecation and rectal hypersensitivity. Contraction and relaxation of her pelvic muscles were recorded with electromyography. Relaxation of the puborectalis muscle improved significantly after three biofeedback sessions. Patient was successfully tapered offlaxatives and has been maintained on linaclotide only. Dyssynergic defecation may be a common finding in Prader-Willi syndrome. In selected cases we recommend anorectal manometry to identify neuromuscular dysfunction and subsequent biofeedback therapy depending on the degree of mental retardation to minimize overuse of laxatives.

Original languageEnglish (US)
Pages (from-to)502-505
Number of pages4
JournalAnnals of Gastroenterology
Volume28
Issue number4
StatePublished - Sep 1 2015

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Keywords

  • Constipation
  • Pelvic floor disorders
  • Prader-Willi syndrome

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Corral, J. E., Kataria, R., Vickers, D., Koutouby, R., & Moshiree, B. (2015). Biofeedback therapy for chronic constipation in a patient with Prader-Willi syndrome. Annals of Gastroenterology, 28(4), 502-505.