Tu1617 – Predicting Successful Outcomes of Anorectal Biofeedback for Fecal Incontinence: Results of Extensive Pyschological Evaluation Before Treatment and Correlations with Treatment Outcomes

Faecal incontinence with concurrent disorders of gut‐brain interaction: A worse outcome

“…This may be a limitation to our study; however, we consider it to provide a thorough insight into the clinical entity of faecal incontinence, especially to capture the low frequency, high impact FI, an entity increasingly realised as important to include in further iterations of Rome diagnostic criteria. 20 In addition, examining the relationship between stool form and faecal incontinence, which was not within our original aims and hypotheses, is an important pathophysiology of faecal incontinence worthy of closer examination. A further limitation is that we excluded spinal cord injury and pelvic radiotherapy in an attempt to study predominant DGBI patients, and that our patient group were undergoing biofeedback, limiting the generalisability of our findings.…”

“…Our findings of significant impact on mental health with increasing number of DGBIs are of great clinical relevance, exemplified by the evidence of increased suicidal ideation in FI patients 17 . Anxiety in FI patients may manifest as a maladaptive locus of control, and that catastrophising and anticipatory concerns may perpetuate symptoms 18–20 . Psychological intervention has been shown to be effective in spinal cord injury with FI 21 and counselling support has been shown to improve symptoms in urinary incontinence patients 16 .…”

“…We chose to include patients who did not meet strict Rome IV criteria (which stipulates at least 2 episodes each 4 weeks). This may be a limitation to our study; however, we consider it to provide a thorough insight into the clinical entity of faecal incontinence, especially to capture the low frequency, high impact FI, an entity increasingly realised as important to include in further iterations of Rome diagnostic criteria 20 . In addition, examining the relationship between stool form and faecal incontinence, which was not within our original aims and hypotheses, is an important pathophysiology of faecal incontinence worthy of closer examination.…”

“… 17 Anxiety in FI patients may manifest as a maladaptive locus of control, and that catastrophising and anticipatory concerns may perpetuate symptoms. 18 , 19 , 20 Psychological intervention has been shown to be effective in spinal cord injury with FI 21 and counselling support has been shown to improve symptoms in urinary incontinence patients. 16 These parallel findings suggest that FI patients with multiple DGBI could also potentially reduce their symptom burden and quality of life with early psychosocial intervention.…”