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Biofeedback training in patients with fecal incontinence
A Glia1, M Gylin, J E Akerlund
1Karolinska Institutet, Department of Surgery, Huddinge University Hospital, Sweden.
Diseases of the Colon and Rectum
|March 26, 1998
Summary
Biofeedback therapy effectively improves fecal incontinence, particularly urge incontinence, by enhancing external anal sphincter function. Better outcomes are linked to higher maximum tolerable volumes and less anal sphincter asymmetry.
Area of Science:
- Gastroenterology
- Pelvic Floor Rehabilitation
- Physiology
Background:
- Fecal incontinence (FI) significantly impacts quality of life.
- Biofeedback training is a non-invasive approach to manage FI.
- Understanding predictors of treatment success is crucial for patient selection and management.
Purpose of the Study:
- To evaluate the functional outcomes of biofeedback training in fecal incontinence patients.
- To correlate treatment results with clinical presentation and anorectal manometry findings.
Main Methods:
- Twenty-six patients with fecal incontinence underwent biofeedback therapy utilizing anorectal manometry for visual feedback.
- Patients were categorized into passive, urge, or combined incontinence subtypes.
- Functional outcomes and manometric parameters were assessed before and after treatment.
Main Results:
- Patients with urge incontinence exhibited lower maximum voluntary contraction pressure and maximum tolerable volume compared to those with passive incontinence.
- Overall, 23% showed excellent improvement, 41% good results, and 36% no improvement immediately post-therapy.
- At a mean 21-month follow-up, 41% reported sustained improvement; higher maximum tolerable volumes and less anal sphincter asymmetry correlated with better outcomes.
Conclusions:
- Biofeedback therapy demonstrates efficacy in improving fecal continence, with sustained benefits observed at follow-up.
- Urge fecal incontinence appears linked to external anal sphincter function and maximum tolerable volume.
- Low maximum tolerable volume and anal sphincter asymmetry are associated with poorer treatment outcomes, suggesting potential targets for intervention.