Acupuncture versus biofeedback training on bowel motility in children with functional constipation: a randomized controlled trial

Abstract

Background and aim Functional constipation (FC) represents a common pediatric disorder that significantly impairs the quality of life (QOL) in affected children. Therefore, the effects of acupuncture versus biofeedback training on bowel motility, stool consistency, anxiety levels, and QOL were compared in children with FC.Participants and methods Sixty children with FC, aged from 7 to 15 years, were randomly assigned to two equal groups (n = 30 each). Group A received acupuncture, while Group B received biofeedback training, both for four weeks. The primary outcome measures were bowel movement and stool consistency, evaluated using the CSBM and BSFS, respectively. The secondary outcome measures included anxiety levels and QOL, evaluated by SAS and PAC-QOL , respectively. The outcome measures were assessed pre- and post-treatment.Results Post-treatment analysis revealed significant within-group improvements for all outcomes (p = .001). Between-group comparisons of post-treatment scores demonstrated that Group B had significantly better outcomes than Group A across all primary and secondary measures. Specifically, in CSBMs with small effect size (r = −.286; p = .01), BSFS and PAC-QOL with moderate effect size (r = −.462; p = .001 and Cohen’s d = 0.58; p = .02), respectively. Notably, large effect sizes for the SAS (Cohen’s d = 1.43; p = .001).Conclusions Both interventions improve bowel motility and stool consistency, reducing anxiety levels, and boosting QOL among children with FC. However four-week trial, biofeedback demonstrated greater short-term improvements compared to acupuncture. Long-term follow-up is necessary to evaluate the durability of these effects and confirm long-term efficacy.