Physiotherapeutic approach to anorectal pain: A systematic review
Abstract
Background: Anorectal pains are part of the functional gastrointestinal disorders (FGIDs) consensus, now called brain-bowel interaction disorders (BGD), defined by the Rome diagnostic criteria. The new
definitions for functional anorectal pain syndrome criteria, according to Roma IV, subcategorize functional anorectal pain in: levator ani syndrome, nonspecific anorectal pain syndrome and proctalgia Fugax.
Objective: To conduct a systematic review of physical therapy interventions used in the treatment of functional anorectal pain.
Methods: The articles search was conducted by researching the databases Science Direct, Medical Literature Analysis and Retrieval System Online (Medline) via the National Center for Biotechnology Information, Virtual Health Library, Scientific Electronic Library Online and SciVerse Scopus. Articles that did not have physical therapy treatment in patients with anorectal pain as main focus were excluded.
Results: 1947 articles were found, but only 3 studies met the inclusion criteria to carry out this systematic review. As physiotherapeutic treatments to rehabilitate this pathology we find biofeedback, electrogalvanic stimulation, electroacupuncture, sitz baths and digital massage. Patients reported improvement, and biofeedback was highlighted as the best therapeutic method. The methodological quality of the included studies was considered moderate based on the PEDro scale analysis, with the average score of 6.
Conclusion: In the articles included in this review, the following therapeutic approaches are reported: electrogalvanic stimulation, electroacupuncture, biofeedback, digital massage and sitz baths. However, biofeedback stood out as the best therapeutic resource. Pelvic physiotherapy is believed to be effective in the treatment of functional anorectal pain, however, it is necessary to carry out more research with a larger sample size and with good methodological quality on this subject.
