Biofeedback therapy improves constipation response rates and symptom scores in adults compared to control groups

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Frontiers in Medicine Published May 29, 2026 Medically reviewed May 29, 2026 Study authors: Yuyuan Tu, Zihao Zhou, Yuanlin Li, Ziyan He, Defu Liao, Zhiren Liu, Boyu Li, Zugang Zhou, Shuangchun… DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Biofeedback therapy increases response rates and bowel frequency for chronic constipation, though quality of life data requires cautious interpretation due to study limitations.

This systematic review and meta-analysis evaluated biofeedback therapy against control groups for treating chronic constipation in adults. The analysis included data from 19 randomized controlled trials to assess overall efficacy and safety profiles across diverse patient populations.

Results indicated a significant increase in overall response rates with a risk ratio of 1.23. Weekly defecation frequency also rose substantially, demonstrating a mean difference of 1.60. These findings suggest the intervention effectively addresses core functional bowel issues in this clinical setting.

Constipation symptom scores decreased markedly, reflecting reduced patient distress. However, quality of life scores also decreased statistically, which warrants further investigation. Safety data showed no significant adverse events or discontinuations between treatment and control arms.

Limitations include small sample sizes and methodological constraints in included studies. Consequently, the reliability of conclusions remains limited despite positive symptom outcomes. Clinicians should consider these factors when recommending biofeedback therapy for constipation management.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

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. 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. 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. 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.