Efficacy of biofeedback therapy for chronic constipation in adults: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND

OBJECTIVE

Chronic constipation (CC) is one of the most common clinical gastrointestinal illnesses, severely impairing patients' physical function and quality of life. Biofeedback therapy (BFT), a painless and non-invasive therapeutic method, has been applied in the clinical treatment of CC, especially dyssynergic defecation constipation. This study aimed to evaluate the efficacy and safety of BFT for the treatment of CC through a meta-analysis.

MATERIALS AND

METHODS

Systematically searched eight databases to identify randomized controlled trials (RCTs) related to CC published from the inception of the database up to August 19, 2025. Methodological quality was assessed using the Cochrane risk of bias tool, and meta-analysis was performed with RevMan 5.4 and Stata 18.0. Evidence quality was evaluated using the GRADE approach.

RESULTS

A total of 3,757 studies were retrieved, and 19 trials were finally selected for inclusion. The results of the forest plot showed that compared with the control group, BFT significantly increased the overall response rate [RR = 1.23, 95% CI = [1.12, 1.34], P < 0.00001], weekly defecation frequency [MD = 1.60, 95% CI = [1.37, 1.82], P < 0.00001]. Additionally, BFT decreased the constipation symptom score [SMD = -1.07, 95% CI = [-1.36, -0.79], P < 0.00001] and quality of life score [SMD = -0.74, 95% CI = [-1.19, -0.29], P = 0.001]. However, there was no statistically significant difference in adverse events between the BFT and control groups.

CONCLUSION

The findings of this study suggest that BFT may have some efficacy in improving symptoms and quality of life in patients with constipation. However, the reliability of the conclusions is limited by the small sample sizes and methodological limitations of the included studies. Future well-designed, large-scale, high-quality RCTs are needed to expand upon these results.