Biofeedback therapy for bowel dysfunction following low anterior resection

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Pelvic Floor Rehabilitation

Background:

• Low anterior resection (LAR) can lead to refractory fecal incontinence and constipation.
• Conventional medications are often ineffective for these post-LAR bowel dysfunctions.

Purpose of the Study:

• To prospectively assess the efficacy of anorectal biofeedback therapy (BF) for patients experiencing bowel dysfunction after LAR.
• To evaluate BF as a treatment for fecal incontinence and intractable constipation refractory to standard medical care.

Main Methods:

• A prospective study involving 11 patients (5 men, 6 women; mean age 64.8 years) with post-LAR bowel dysfunction.
• Patients underwent 4 outpatient sessions of anorectal biofeedback therapy.
• Assessment included continence questionnaires and anorectal physiology tests before and after therapy.

Main Results:

• Significant reduction in weekly fecal incontinence episodes (14.8 to 1.8) and anti-diarrheal medication use in incontinent patients.
• Marked improvement in weekly stool frequency for patients with intractable constipation (3 to 8.9).
• No significant changes in anorectal physiology parameters were observed post-BF.

Conclusions:

• Anorectal biofeedback therapy is a safe and effective treatment for refractory fecal incontinence and constipation following low anterior resection.
• BF offers a non-invasive option for managing persistent bowel dysfunction after LAR, with no reported regressions or complications at follow-up.