Z Gastroenterol 2006; 44 - A51
DOI: 10.1055/s-2006-943417

Effect of biofeedback therapy on anorectal functions of patients with fecal incontinence

A Illés 1, C Csizmadia 1, L Nagy 1, B Pordány 1, S Undi 1, Á Király 1
  • 13rd. Dept. of Medicine, Medical University of Pécs

Fecal incontinence is a common health care problem affecting 1–7% of the population.

The aim of this study was to determine the efficacy of biofeedback therapy in patients with passive anal incontinence.

Patients and methods: 8 patients (1 male, 7 females, median age: 54yrs, range: 21–72yrs) were recruited into the biofeedback program. Colonoscopy and defecography were performed to close out structural and functional abnormality of the rectosigmoideal region. Structural sphincter damage and perineal body disruption were closed out by anal utrasonography. Patients with perception abnormality were not eligible for the study. The severity of incontinence was determined by the Cleveland score system. Vector volume, sphincter length, basal pressure, squeeze, endurance squeeze, fatigue slope was determined before and after biofeedback therapy. Biofeedback was performed using by a four channel, water perfused manometry system, each session lasted for 20min. Biofeedback was continued while patients subjective symptoms decreased to „improved“ or „cured“ level. Median time was 13.5 weeks for symptom relief.

Results: Average length of the anal sphincter was 2.6±1cm. Biofeedback led to a significant increase of the continence score (15.25±2.3 vs. 5.25±4 p<0.05). Both squeezing (64.8±14.2 vs. 71.9±11mmHg, NS) and resting pressure (28.32±6.8 vs. 33.2±4.9mmHg, NS) as well as endurance squeezing pressure (29.8±4.5 vs. 33.5±5.3mmHg, NS) prone to increase, but no statistical significance could be obtained during the training period. The maximal tolerable volume were increased (168.7±20.4 vs. 333.7±30.6ml, p<0.05) and fatigue slope was decreased (0.37±0.07 vs. 0.18±0.02mmHg/s, p<0.05) significantly.

Conclusion: The improvement of ability to sustain a squeeze for 30 seconds, a decreased fatigue rate and an increased compliance of the rectum might be involved in the beneficial effect of biofeedback therapy in the control of anorectal function.

This study was supported by the grant ETT 550/2003.