Biofeedback therapy

Biofeedback therapy is a behavioral training technique that is based on operant conditioning, and it utilizes visual or auditory feedback for modifying an inappropriate behavior. Biofeedback therapy aims to restore normal coordination of muscles that are involved in defecation and continence. For dyssynergic defecation, biofeedback corrects its underlying pathophysiology and both short-term and long-term efficacy greater than the standard treatment have been reported in several randomized controlled trials. For fecal incontinence, well-designed studies have confirmed long-term benefits of biofeedback over pelvic floor exercise. Although the protocols of biofeedback have not been standardized, with a wide variety of reported techniques, and data is often insufficient to determine the most effective modality, there is high quality evidence to support this therapy in dyssynergic defecation and fecal incontinence after failed conservative treatment. In this review, we focus on manometry-based biofeedback therapy for dyssynergic defecation and fecal incontinence.