Anismus is a frequent cause for chronic constipation. Biofeedback may be a promising means of alleviating the symptoms of anismus. The aim of this meta analysis was to define the clinical effectiveness of biofeedback. A literature research identified 11 controlled trials that met the inclusion and exclusion criteria. Their methodologies varied considerably. The study groups differed particularly with regard to the chronicity of anismus, and the type and frequency or intervention. Nevertheless, the success rates were surprisingly uniform. On average, patients reported a considerable improvement of constipation following biofeedback training. Most studies adhered to a cross-over design and did not compare treatment to biofeedback. Even though suggestive and promising, this collective evidence does not allow firm conclusions regarding the clinical effectiveness of relaxation as a treatment for anismus. The findings could also be compatible with a powerful placebo effect of biofeedback therapy. The effectiveness of biofeedback in alleviating the symptoms of anismus ought to be evaluated in a randomized, placebo-controlled double-blind trial.

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