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CC BY 4.0 · Journal of Coloproctology 2025; 45(03): s00451811261
DOI: 10.1055/s-0045-1811261
Original Article

Pelvic Floor Physiotherapy with Biofeedback Improves Constipation in Post-Bariatric Surgery Patients

Authors

  • Marcieli Schuster 

    1   Graduate Program in Biosciences and Health, Center for Biological and Health Sciences, Western Paraná State University (UNIOESTE), Cascavel, PR, Brazil

  • Caroline Dresch Sabadin 

    2   Western Paraná State University (UNIOESTE), Cascavel, PR, Brazil

  • Cláudia Silveira Viera 

    3   Center for Biological and Health Sciences, Western Paraná State University (UNIOESTE), Cascavel, PR, Brazil

  • Maria Lúcia Bonfleur 

    3   Center for Biological and Health Sciences, Western Paraná State University (UNIOESTE), Cascavel, PR, Brazil

Funding This study forms part of the PhD Thesis of Marciele Schuster and was supported by grants from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, PROAP, Process N.: 888881.690222/2022-01).
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Abstract

Bariatric surgery has proven effective in managing severe obesity but may lead to complications involving pelvic floor function and anorectal health. This retrospective cohort study examined the effect of pelvic floor physical therapy (PFPT) with surface electromyography (EMG) biofeedback on anorectal alterations in individuals following surgery. The analysis included patients who underwent either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) from 2015 to 2019 and subsequently experienced proctological complaints. Data on clinical profiles, demographics, and pelvic floor functionality were extracted from medical records. The PFPT protocol consisted of personalized weekly sessions using surface EMG feedback, with pre- and post-treatment EMG data collected for comparison. Out of 1,639 patients who underwent bariatric procedures during the period, 477 (29%) developed proctological symptoms, with constipation being the most frequent (42%). Nevertheless, only 64 (13.42%) were referred to as PFPT. Anorectal manometry assessments showed that most of these individuals had reduced resting and contraction pressures, generally without signs of anismus. Notably, differences in muscle function patterns were observed between surgical techniques. After undergoing PFPT, participants presented increased EMG activity and substantial relief from constipation. These results highlight the frequent occurrence of anorectal dysfunction after bariatric surgery and support PFPT with EMG biofeedback as a valuable non-invasive intervention for symptom relief and functional recovery.

Keywords

bariatric surgery - electromyography - pelvic floor - rectum/pathology


Publication History

Received: 09 April 2025

Accepted: 21 July 2025

Article published online:
25 September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Marcieli Schuster, Caroline Dresch Sabadin, Cláudia Silveira Viera, Maria Lúcia Bonfleur. Pelvic Floor Physiotherapy with Biofeedback Improves Constipation in Post-Bariatric Surgery Patients. Journal of Coloproctology 2025; 45: s00451811261.
DOI: 10.1055/s-0045-1811261