Biofeedback therapy for fecal incontinence

Abstract

Twenty-five patients (ages 10 to 79 years; average, 48 years) with fecal incontinence underwent anorectal manometry with a three-balloon system connected to a physiograph. On a basis of manometric criteria showing the presence of rectal sensation, 17 patients underwent biofeedback conditioning. Underlying disorders included irritable bowel syndrome, diabetes mellitus, anal sphincter damage from surgery or disease, and neurogenic anal dysfunction. Twelve of the 17 patients who received biofeedback training had significant improvement in bowel soiling. Follow-up periods ranged from 2 to 38 months (mean, 15 months). There were no significant differences in threshold of rectal sensation, relaxation of the internal anal sphincter, and pre- and postbiofeedback thresholds of external anal sphincter contraction between responders and nonresponders. Minimal criteria for successful treatment appeared to be ability to sense rectal distension, good motivation, and absence of significant psychological dysfunction. Biofeedback conditioning is a simple and effective technique in the treatment of selected patients with fecal incontinence.