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Treatment of faecal incontinence in children with spina bifida by biofeedback and behavioural modification
1Dept. of Surgery, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.
Insights
Biofeedback operant conditioning and behavioral modification helped two of three children with myelomeningocele achieve voluntary bowel movements. This approach shows promise for treating neurogenic bowel incontinence in spina bifida patients.
Area of Science:
- Pediatric neurology
- Rehabilitation medicine
- Behavioral therapy
Background:
- Faecal incontinence significantly impacts social and physiological well-being.
- Neurogenic bowel dysfunction affects over 90% of spina bifida patients, posing a major habilitation challenge.
- Effective management strategies for encopresis in pediatric neurogenic bowel are crucial.
Purpose of the Study:
- To evaluate the efficacy of Biofeedback operant conditioning combined with behavioral modification for treating encopretic children with myelomeningocele.
- To assess the potential for self-initiated bowel movements in this patient population.
Main Methods:
- Three encopretic children with myelomeningocele (neurological levels T-10, T-11, T-12) underwent treatment.
- Intervention involved an average of 10 Biofeedback sessions (30-45 minutes each) per child.
- Daily behavioral modification techniques were integrated with Biofeedback therapy.
Main Results:
- Two out of the three patients achieved voluntary bowel movements post-treatment.
- One patient did not show improvement with the applied therapy.
- The treatment demonstrated a positive outcome in a majority of the participants.
Conclusions:
- Biofeedback operant conditioning and behavioral modification represent a potentially simple and effective technique.
- This combined approach may offer a viable solution for managing encopresis in patients with meningomyelocele.
- Further research is warranted to optimize this therapeutic strategy.
Abstract:
Faecal incontinence may lead to serious social and physiological disturbances. Over 90% of patients with spina bifida have varying degrees of neurogenic bowel with disturbances of faecal control. This is a serious habilitation problem in these patients. Three encopretic children with myelomeningocele were treated by Biofeedback operant conditioning and behavioural modification to self-initiate bowel movements. Their neurological levels were T-10; T-11; T-12. Each child had a mean of 10 Biofeedback sessions each of 30-45 minutes, combined with daily behavioural modification. Two patients improved and have voluntary bowel movements. Therapy failed in one patient. We conclude that Biofeedback operant conditioning combined with specific behavioural modification may become a simple technique to treat encopretic patients with meningomyelocele.