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Functional changes after physiotherapy in fecal incontinence.

Annette C Dobben1, Maaike P Terra, Bary Berghmans

  • 1Department of Radiology, Academic Medical Center, G1-228, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. a.c.dobben@amc.uva.nl

International Journal of Colorectal Disease
|October 26, 2005
PubMed
Summary

Pelvic floor physiotherapy improved anorectal function, including squeeze pressure and sensation, in patients with fecal incontinence. However, these functional improvements did not consistently reduce incontinence symptoms.

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Area of Science:

  • Gastroenterology
  • Pelvic Floor Rehabilitation
  • Anorectal Physiology

Background:

  • Physiotherapy is a common treatment for fecal incontinence.
  • The relationship between physiotherapy-induced anorectal function changes and symptom improvement remains unclear.

Purpose of the Study:

  • To prospectively investigate changes in anorectal function following physiotherapy.
  • To determine if these functional changes correlate with improvements in fecal incontinence scores.

Main Methods:

  • 266 patients with fecal incontinence underwent anorectal manometry, sensitivity, and capacity measurements.
  • Measurements were taken before and after nine sessions of pelvic floor physiotherapy.
  • Findings were compared with changes in the Vaizey incontinence score.

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Main Results:

  • Significant improvements observed in squeeze pressure, urge sensation threshold, and maximum tolerable volume post-physiotherapy.
  • No correlation found between improvement extent and age, incontinence duration, menopause, or endosonography findings.
  • Vaizey score improvement moderately correlated with increased incremental squeeze pressure and decreased anal mucosal sensitivity.

Conclusions:

  • Pelvic floor physiotherapy enhances specific anorectal functions like squeeze pressure and sensation.
  • Improved anorectal function does not invariably lead to a reduction in fecal incontinence complaints.