Diseases of the Colon & Rectum

, Volume 41, Issue 3, pp 359–364 | Cite as

Biofeedback training in patients with fecal incontinence

  • Abdulhakim Glia
  • Meta Gylin
  • Jan Erik Åkerlund
  • Ulrik Lindfors
  • Greger Lindberg
Original Contributions
  • 39 Downloads

Abstract

PURPOSE: This study was undertaken to assess the functional results of biofeedback training in patients with fecal incontinence in relation to clinical presentation and anorectal manometry results. METHODS: Twenty-six consecutive patients with fecal incontinence were treated with biofeedback training using anorectal manometry pressure for visual feedback. Ten patients had passive incontinence only, six patients had urge incontinence, and ten patients had combined passive and urge incontinence. RESULTS: Patients with urge incontinence had a lower maximum voluntary contraction pressure (92 ± 12 mmHg) and lower maximum tolerable volume (78 ± 13 ml) than patients with passive incontinence (140 ± 43 mmHg and 166 ± 73 ml). Twenty-two patients completed the treatment, five patients (23 percent) showed excellent improvement, nine patients (41 percent) had good results, and eight (36 percent) patients showed no improvement. At follow-up on average of 21 months after therapy, 41 percent of our patients reported continued improvement. The maximum tolerable volume was higher in those with excellent (140.4 ± 6.8 ml) or good (156.3 ± 6.64 ml) results of therapy than it was in those with poor results (88.5 ± 2.5 ml). Greater asymmetry of the anal sphincter also correlated to poor results. CONCLUSION: Biofeedback therapy improved continence immediately after training and at follow-up after 21 months, but the initial results were better. The urge fecal incontinence seems to be related to function of the external anal sphincter and to the maximum tolerable volume. Low maximum tolerable volume and anal sphincter asymmetry were associated with a poor outcome of therapy

Key words

Constipation Biofeedback Manometry 

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Copyright information

© The American Society of Colon and Rectal Surgeons 1998

Authors and Affiliations

  • Abdulhakim Glia
    • 1
  • Meta Gylin
    • 1
  • Jan Erik Åkerlund
    • 1
  • Ulrik Lindfors
    • 1
  • Greger Lindberg
    • 1
  1. 1.From the Karolinska Institutet, Departments of Surgery and Medical and Surgical Gastroenterology and HepatologyHuddinge University HospitalHuddingeSweden

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