Background: Encopresis with dyssynergic constipation is very common in pediatric population. Biofeedback therapy could be more effective than laxatives, and it has no known adverse effects. We aimed in this study to evaluate the role of biofeedback training in persistent encopresis in children with dyssynergia.

Methods: A randomized clinical trial was carried out on 38 children with dyssynergic- defecation who visited GIT motility unit. A multimodal treatment of 6 weeks. Children were randomized into two groups. Each group received dietary, toilet advice, enemas and oral laxatives. One group also received 6 biofeedback training sessions.

Results: Both groups showed improvement in constipation-related symptoms and quality of life during the course of treatment (within biofeedback group, there is significant decrease in scores from 85.74 to 0 while within conventional treatment group, the decrease was from 87.63 to 28), there was statistically significant decrease in incontinence score among the studied groups; with higher scores reported among conventional treatment patients, both groups differed significantly as regard remission at 6th week and 6th months (p=0.022, 0.012 respectively). Full remission occurred in 42.1% versus 78.9% within conventional group versus biofeedback groups respectively at 6th week. At 6th month, full remission occurred in 52.63% versus 89.47% within conventional group versus biofeedback groups respectively at 6th week.

Conclusions: Biofeedback combined with conventional treatment could be superior to the conventional treatment alone in management of encopretic patients with dyssynergic defecation, it improved the quality of life, maintaining the continence response and correcting the physiological manometric parameters.