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Dyssynergic DefecationNCT07225803

Management of Dyssynergic Defecation

A study testing Biofeedback and Inspiratory muscle training (IMT) in people with Dyssynergic Defecation and Constipation, run by Mayo Clinic at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this research is to better understand constipation and improve biofeedback treatments. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Dyssynergic Defecation, Constipation
What is being tested?
Biofeedback and Inspiratory muscle training (IMT)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
1 siteUnited States
Study dates
18 Jul 2025to Jul 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men and women aged 18-80 years who are able and willing to provide written informed consent and to comply with the requirements for the entire study
  • Satisfy Rome III criteria for functional constipation and/or irritable bowel syndrome as assessed by questionnaires and objective evidence of dyssynergic defecation on anorectal testing

Who cannot join

  • Clinical evidence of significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric or other diseases that may interfere with the objectives of the study and/or pose safety concerns.
  • History of total, hemi- or subtotal colectomy at any time or other abdominal operations within 60 days prior to entry into the study. Segmental resection of the colon (e.g. sigmoid resection) for diverticulitis will be permitted.
  • Current anal fissure
  • Clinically significant structural abnormalities (eg, rectocele > 4cm, large enterocele, full thickness rectal prolapse) that, in the opinion of the investigator, are likely contributing to symptoms
  • Current or past history of colon or rectal cancer, scleroderma, inflammatory bowel disease, congenital anorectal abnormalities, solitary rectal ulcer syndrome, rectal resection or pelvic irradiation
  • Pregnant or nursing women, prisoners and institutionalized individuals
Show all 11Show fewer
  • BMI >35 kg/m2
  • Use of opioid analgesics or GLP-1 receptor agonists. Patients on opioids will be allowed to participate if they have discontinued them for at least 1 week before the date of screening and are willing to stay off them for the duration of the study.
  • Current use of anticholinergics (eg. amitriptyline, hyoscyamine). Patients who use low dose tricyclic antidepressants (nortriptyline or amitriptyline up to 50 mg/day) will be eligible provided they do not increase the dose during the study period. Patients on higher doses are eligible to participate if it is safe and they are willing to reduce their medication dose at least 3 days (72 hrs) before the date of screening and are willing to stay off them till the study is complete.
  • Current use of laxatives (Ex-lax, senna, herbal supplements), linaclotide, lubiprostone, and prucalopride to treat constipation- patients using these medications will be eligible to participate if they can discontinue the medication at least 3 days (72 hrs.) before the date of screening and are willing to stay off them till the study is complete (As detailed later, all participants can use Miralax throughout the study).
  • Any other factors that increase the risk to participants of participating in the study and/or undermine the integrity of the data.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Kelly J. Feuerhak, RN, CCRP contact

507-255-6802

feuerhak.kelly@mayo.edu

United States1 site, 1 recruiting
  • Mayo Clinic

    Rochester, Minnesota, 55905

    Kelly J. Feuerhak, RN, CCRP, 507-255-6802, feuerhak.kelly@mayo.edu

    Recruiting

Other trials in United States

About this study

The purpose of this research is to better understand constipation and improve biofeedback treatments.

Being tested
Biofeedback, Inspiratory muscle training (IMT)
Medical subject headings
Constipation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • BiofeedbackBehavioural

    During anorectal biofeedback therapy, subjects are coached to improve abnormal patterns while observing activity recorded by manometry and/or surface EMG (electromyography) on a computer monitor while seated on a chair or a commode.

  • Inspiratory muscle training (IMT)Behavioural

    Subjects will engage in inspiratory muscle training (IMT) that is tailored to the baseline performance of the individual.

Study groups in NCT07225803
Study groupRoleWhat they receive
Biofeedback and inspiratory muscle training (BFT Plus)ExperimentalSubjects in the BFT Plus arm will participate in a minimum of 6 up to a maximum of 20 biofeedback sessions, with each session lasting approximately 60 minutes. In addition, subjects will engage in inspiratory muscle training (IMT) at home.
Receives: Behavioral: Biofeedback; Behavioral: Inspiratory muscle training (IMT)
Biofeedback only (BFT Alone)Active comparatorSubjects in the BFT Plus arm will participate in a minimum of 6 up to a maximum of 20 biofeedback sessions, with each session lasting approximately 60 minutes.
Receives: Behavioral: Biofeedback

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in rectoanal gradient during evacuation

    Rectoanal gradient during evacuation is the pressure difference between the rectum and the anal canal during simulated evacuation, measured in millimeters of mercury (mmHg).

    Measured: Baseline, through study completion, an average of 16 weeks

  2. Change in rectal pressure during evacuation

    Rectal pressure during evacuation is the difference in rectal pressure during - before evacuation. Results are measured in millimeters of mercury (mmHg).

    Measured: Baseline, through study completion, an average of 16 weeks

  3. Change in balloon expulsion time

    Rectal balloon expulsion directly assesses evacuation. Patients will be asked to expel a rectal balloon inflated up to 50 ml of water. The time required to expel the balloon will be measured and reported in seconds.

    Measured: Baseline, through study completion, an average of 16 weeks

  4. Change in rectal emptying time

    Rectal emptying will be assessed via fecoflowmetry by measuring the time required to defecate (seconds) artificial stool from the rectum

    Measured: Baseline, through study completion, an average of 16 weeks

  5. Change in rectal emptying rate

    Rectal emptying will be assessed via fecoflowmetry by measuring the amount (gm) of artificial stool from the rectum. The 2 metrics - amount and time - are integrated to measure amount (gm) evacuated per unit time (second) (gm/sec).

    Measured: Baseline, through study completion, an average of 16 weeks

Secondary outcomes (23)
  1. Change in Patient Assessment of Constipation-Symptoms (PAC-SYM) questionnaire

    The PAC-SYM questionnaire assesses the severity of patient-reported symptoms related to constipation. The questionnaire is divided into three symptom subscales: abdominal (four items); rectal (three items); and stool (five items). Items are scored on 5-point Likert scales, with scores ranging from 0 to 4 (0 = 'symptom absent', 1 = 'mild', 2 = 'moderate', 3 = 'severe' and 4 = 'very severe'). A mean total score in the range of 0-4 is generated by dividing the total score by the number of questions completed; the lower the total score, the lower the symptom burden. Scores range from 0 to 48.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  2. Change in Patient Assessment of Constipation - Quality of Life (PAC-QOL) questionnaire

    The PAC-QOL questionnaire is a patient-reported outcome measure to evaluate quality of life in constipated persons. The questionnaire is divided into four subscales: worries and concerns (11 items), physical discomfort (4 items), psychosocial discomfort (8 items), and satisfaction (5 items). Scale scores represent average item scores and range from 0 to 4, where higher scores represent poorer quality of life. Scores range from 0 to 112.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion , 12 months post completion

  3. Physical Activity Rating Scale

    Physical Activity Rating is a questionnaire for categorizing physical activity level, which is used in the equation for the non-exercise fitness test. The Physical Activity Rating is a score value between 0 to 7. The non-exercise fitness test of VO2max, a measure of cardiovascular fitness, will be calculated using the following equation:

    56.363 + 1.921 (Physical Activity Rating) - 0.381(Age) - 0.754(Body Mass Index) + 10.987(Sex: 0 for women, 1 for men)

    Measured: Baseline

  4. Quebec User Evaluation of Satisfaction with Assistive Technology questionnaire

    Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 11-item questionnaire is a standardized tool to measure the satisfaction of an individual who is using an assistive device. It inquiries about the assistive device itself: dimensions, weight, ease of adjustment, safety, durability, ease of use, comfortability, and effectiveness; and service: service delivery, maintenance, professional services, and follow up services. Each question is answered on a Likert scale, where 1 = not satisfied at all, and 5 = very satisfied. Possible scores range from 11 to 55.

    Measured: through study completion, an average of 16 weeks

  5. Change in stool frequency

    Daily number of bowel movements will be self-reported by participants via a bowel diary.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  6. Change in stool consistency

    Daily stool consistency will be self-reported by participants via a bowel diary by using the Bristol Stool Chart. Participants will compare stool's appearance to the 7 types and selecting the one that most closely matches. Type 1-2 indicate constipation, Type 3-4 are ideal stools as they are easier to pass, and Type 5-7 may indicate diarrhea and urgency.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  7. Change in anal digitation

    The total number of times anal digitation was required to achieve a bowel movement will be self-reported via the bowel diary.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  8. Change in sense of incomplete evacuation

    The total number of times a participant felt a sense of incomplete evacuation after a bowel movement will be self-reported via the bowel diary.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  9. Change in spontaneous bowel movements

    The total number of times a participant achieves a spontaneous bowel movement will be self-reported via the bowel diary.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  10. Change in pain during bowel movements

    Pain during bowel movements will be self-reported by participants via the bowel diary using a 4-point Likert scale (0 = None, 1 = Mild, 3 = Moderate, and 4 = Severe).

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  11. Change in bowel symptoms before and after biofeedback therapy

    Bowel symptoms pre and post biofeedback therapy will be assessed using a self-reported questionnaire. The survey includes Severity of constipation, satisfaction with bowel movements, satisfaction with current treatment of constipation, severity of constipation compared to baseline, adequate relief of constipation, use of laxatives, and severity of abdominal bloating and distention. Impact of constipation on 15 QOL domains.

    Measured: Baseline, through study completion, an average of 16 weeks, 3 months post completion, 12 months post completion

  12. Change in Hospital Anxiety and Depression (HAD) score

    The Hospital Anxiety and Depression (HAD) is a self-reported 14 item questionnaire asking participants to reflect on their mood in the past week. . Each item is rated on a 4-point scale, for a total score ranging from 0-21 for each subscale. A higher score indicates higher distress.

    Measured: Baseline, through study completion, an average of 16 weeks

  13. Change in forced vital capacity

    Forced vital capacity (FVC) is the the total volume of air exhaled with maximal effort, and is measured using a spirometer (reported in liters).

    Measured: Baseline, through study completion, an average of 16 weeks

  14. Change in forced expiratory volume

    Forced expiratory volume (FEV) is the total volume of air exhaled with maximal effort, and is measured using a spirometer (reported in liters).

    Measured: Baseline, through study completion, an average of 16 weeks

  15. Change in forced expiratory time

    Forced expiratory time (FET) is the time taken to exhale the greatest volume of air from the lungs as possible and is measured using a spirometer (reported in seconds).

    Measured: Baseline, through study completion, an average of 16 weeks

  16. Change in peak inspiratory flows

    Peak inspiratory flow (PIF) is the maximum volume and rate of air that can be forcefully inhaled out of the lungs, and is measured using a spirometer (reported in liters per second (L/sec)).

    Measured: Baseline, through study completion, an average of 16 weeks

  17. Change in peak expiratory flows

    Peak expiratory flow (PEF) is the maximum volume and rate of air that can be forcefully exhaled out of the lungs and is measured using a spirometer (reported in in liters per second (L/sec)).

    Measured: Baseline, through study completion, an average of 16 weeks

  18. Change in forced expiratory volume/forced vital capacity ratio

    The total volume of air exhaled with maximal effort / The volume of air exhaled with maximum effort in the first second (reported as percentage).

    Measured: Baseline, through study completion, an average of 16 weeks

  19. Change in forced expiratory flow at 25-75% of forced vital capacity

    The average flow from the point at which 25% of the forced vital capacity has been exhaled to the point at which 75% of the forced vital capacity has been exhaled. A reduced forced expiratory flow 25-75% is a marker of small airway obstruction.

    Measured: Baseline, through study completion, an average of 16 weeks

  20. Change in forced expiratory flow at 50% of forced vital capacity

    The flow rate at the point at which 50% point of the forced vital capacity has been exhaled, and is a marker of small airway obstruction.

    Measured: Baseline, through study completion, an average of 16 weeks

  21. Change in forced inspiratory vital capacity

    Forced inspiratory vital capacity is the maximum volume of air that can be inhaled after a full expiration (reported in liters).

    Measured: Baseline, through study completion, an average of 16 weeks

  22. Change in peak inspiratory pressure

    Peak inspiratory pressure is the peak pressure during forceful inspiration against an occluded airway (Mueller maneuver), reported in liters per minute (L/min)

    Measured: Baseline, through study completion, an average of 16 weeks

  23. Change in peak expiratory pressure

    Peak expiratory pressure is the peak pressure during forceful expiration against an occluded airway (Valsalva maneuver), reported in liters per minute (L/min)

    Measured: Baseline, through study completion, an average of 16 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Nov 2025
  2. Study start18 Jul 2025
  3. Primary completionJul 2028 (estimated)
  4. Study completionJul 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07225803
Sponsor's protocol ID
25-003767
Status last verified
Oct 2025
First submitted
17 Oct 2025
Last updated
10 Nov 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Biofeedback and Inspiratory muscle training (IMT) in people with Dyssynergic Defecation and Constipation, run by Mayo Clinic at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 10 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Kelly J. Feuerhak, RN, CCRP (507-255-6802, feuerhak.kelly@mayo.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in rectoanal gradient during evacuation (time frame: Baseline, through study completion, an average of 16 weeks). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Nov 2025.

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