Biofeedback therapy for bowel problems in adults after surgical treatment for childhood Hirschsprung's disease

Abstract

Objective: To describe the use of biofeedback therapy in management of bowel symptoms after definitive surgery for Hirschsprung's disease.

Methods: This study describes two cases that exemplify the complex nature of these problems. These patients presented with constipation and faecal seepage several years after receiving treatment for Hirschsprung's disease. The approach to management of these patients including the use of biofeedback therapy is described.

Results: After biofeedback therapy, there was improvement in bowel symptoms in both subjects. In case 1 (constipation), stool frequency increased from 0.5-1 time/week to 5-6 times/week together with improved stool consistency. In case 2 (faecal seepage), the number of incontinence episode decreased from >1/day to complete continence, together with decreased stool frequency. They were still satisfied with their bowel movement at 1-year follow-up.

Conclusion: Recognition of the underlying problems and therapy directed towards correcting these abnormalities may lead to significant symptomatic improvement in these patients.