[Biofeedback in the treatment of fecal incontinence]

Four hundred and thirty seven consecutive patients with problems of motility were referred to, and examined at our third-level unit from 1987 to 1993. Forty seven (mean age 36.3 +/- 3.8, range 5-76 years; 25 females) fulfilled the established criteria for fecal incontinence. The mean period of total incontinence was 55.4 +/- 7.6 months (range 6 months to 21 years), with episodes of incontinence of 2.4 +/- 0.2 (range 1-7 a day). All patients were asked to complete a questionnaire in order to validate the incontinence diagnosis. A complete clinical history was obtained from each patient, and they were given laboratory tests, barium enema, recto-sigmoidoscopy, rectal sensitivity tests, recto-anal manometry, and biofeedback without electronic equipment. Twenty one normal subjects were used as a control group. Patients with fecal incontinence showed less rectal sensitivity (P < 0.01). The spontaneous recto-anal inhibitory reflex was not present in all forty seven. All the patients that completed their treatment were completely cured in a period of 4 +/- 0.5 months (range 16 days to 15 months), and follow-up continued for one to eight years. To sum up, this new therapeutic approach is beneficial independent of age, duration and cause of incontinence. The treatment is patient-friendly and economical. Doctors have changed their attitudes, and the quality of life of the patient has improved dramatically, thus providing clinical signification, and proof of the validity and applicability of this treatment: using biofeedback without electronic equipment in the treatment of fecal incontinence.