Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults

Raising awareness about fecal incontinence

“…Follow-up of some prevention measures beyond the shortterm appears indicated as possible beneficial effects of perinatal pelvic floor muscle training were not sustained over time. 24,25 Another desirable and useful outcome of risk identification studies would be development of a standard, practical screening tool for fecal incontinence. Because factors associated with fecal incontinence for community-living and nursing home individuals were different, 2 separate screening instruments for identified high-risk groups are likely needed.…”

Predictors of a favorable outcome of physiotherapy in fecal incontinence: Secondary analysis of a randomized trial

“…15 In addition to the predictive factors found in our study, agreement exists on several factors that seem to influence the outcome of physiotherapy treatment, such as patienttherapist interaction 22 and patient motivation. 4 Patients with severe neurological deficits, substantial co-morbidity or cognitive impairments are unlikely to benefit from physiotherapy treatment. 30…”

“…Rectal balloon training was done according to the sensory and coordination training protocol. 3,4 Participating physiotherapists were instructed by means of a written protocol, and an educational meeting in which we showed them an instruction film on rectal balloon training. Ultimately, 25 out of the 90 trained physiotherapists treated all included patients.…”

“…3 However, a Cochrane review of controlled studies of biofeedback and exercises for FI showed insufficient evidence to determine which patients are most likely to have a favorable outcome. 4 Identifying patient characteristics that are amenable to change by physiotherapy treatment may prevent referral to surgical interventions, which are considered equally effective, but costly and burdensome because of their invasive nature and serious adverse events. 5,6 Identifying predictors based on pre-treatment assessments is essential to support early clinical decisionmaking and may lead to more realistic expectations of the outcome, as well as a more efficient use of resources and referral.…”

Anorectal Physiology: Test and Clinical Application

“…The purpose of this therapy is to enhance the contraction capacity of the external sphincter muscles and to teach patients to perceive and react even if the rectum is dilated slightly. According to the Cochrane review reported in 2000, proofs of biofeedback therapy being effective for the reduction of anal incontinence were concluded not to be sufficient [21]. Nonetheless this therapy has advantages in that it is non-invasive and safe.…”