Journal of Novel Physiotherapies
Open Access

Abstract

Statement of the Problem: Dyssynergic defecation (DD) is a common digestive complaint which has an adverse impact on psychological health and quality of life of the patients. DD or paradoxical puborectalis contraction syndrome, which is one of the most common functional defecation disorders, has an unclear etiology. The abnormal pattern of muscle activity may be a result of an acquired behavioral and cognitive defecation disorder. This study aimed to determine the effects of cognitivebehavior therapy on physical and mental health of the DD patients. Methodology & Theoretical Orientation: In a randomized clinical trial, 45 patients were divided into three study groups that received biofeedback therapy with cognitive-behavior therapy, biofeedback therapy and standard therapy. In order to assess the effects of cognitive-behavior therapy on the somatic symptoms, the culturally-adapted version of Short Form-36 and Beck Depression Inventory questionnaires were used, before and after treatment. Also, symptomatic changes were measured according to a constipation scoring system, i.e., the Agachan Scoring System with minimum score of 0, and maximum of 30, which represented the severity of the constipation. Digital rectal examination was used to assess the presence of paradoxical contraction of the pubrectalis muscle. Findings: The results showed that improvement of dyssynergic defecation and quality of life and decrease of depression in cognitive-behavioral therapy with biofeedback therapy group were more than the other two groups. Conclusion & Significance: Inability to overcome the cycle of disease and treatment efforts will lead to increased depression. Cognitive behavioral therapy with the reconstruction process of beliefs and cognitions about disability and disease can decrease depression and improve the quality of life. Enhancement of mood and quality of life affect the individual care which leads to decrease the time in recovery process.

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