Prevalence of Dyssynergic Defecation among children aged 5 to 12 years with Functional constipation and the role of biofeedback therapy among children with Dyssynergic Defecation

Functional constipation is a leading cause of pediatric gastroenterologist consultations, comprising approximately 25% of cases, with a prevalence rate of up to 32.2%. As of now, there is no consensus as to how long to continue treatment for functional constipation in children and there is paucity of data on High resolution anorectal manometry findings in children with functional constipation. Studies have reported the prevalence of Dyssynergic defecation in children till 80%. Dyssynergic defecation (DD) is one of the cause of failure of standard treatment and longer treatment. Biofeedback id the mainstay of treatment for adults with Dyssynergic defecation At present, due to under recognition and underreporting of this entity, diagnostic criteria for DD are based on studies in adults and the utility of biofeedback is hardly studied in children. Hence this study is aimed at determining the role of biofeedback with laxatives compared to laxatives.

 Hypothesis: As Dyssynergic Defecation is increasingly prevalent in the children with constipation between 5-12 years, and high rate of incomplete cure and relapse is identified, it is hypothesized that treatment with biofeedback therapy  in addition to laxatives will achieve a higher rate of response compared to the group of laxatives alone.