Can biofeedback therapy improve anorectal function in fecal incontinence?

Satish S.C. Rao, Kimberly D. Welcher, Janet Happel

Research output: Contribution to journalArticlepeer-review

84 Scopus citations


Background: Although biofeedback treatment ameliorates symptoms in patients with fecal incontinence, whether it improves anorectal function is unclear. Aim: To examine prospectively whether biofeedback therapy influences objective and subjective parameters of anorectal function and whether it improves outcome. Methods: Nineteen consecutive patients (females = 17) with fecal incontinence for over 1 year, underwent a three-phase outpatient treatment program. This program consisted of pelvic muscle strengthening exercises (phase 1), 1-h biofeedback therapy sessions twice a week (phase 2), and reinforcement sessions at 6 wk, 3, 6, and 12 months (phase 3). The number of sessions in phase 2 were customized for each patient. Anorectal manometry, saline continence test, prospective stool diaries, and bowel satisfaction scores were used to assess the changes in bowel function before and 1 year after therapy. Results: After biofeedback therapy, the anal squeeze sphincter pressure (p < 0.05), the duration of squeeze (p < 0.001), and the capacity to retain liquids (p < 0.05) increased. Rectoanal coordination also improved with a reduction (p < 0.001) in rectal pressure and an increase (p < 0.05) in the continence index. Threshold volumes fur first perception and desire to defecate decreased (p < 0.05). The number of therapy sessions varied, mean (range) = 7 (4-13). Stool frequency and the number of incontinence episodes decreased (p < 0.001). Bowel satisfaction score improved (p < 0.001). Conclusions: Biofeedback therapy is effective and improves objective and subjective parameters of anorectal function in patients with fecal incontinence. Customizing the number of sessions and providing periodic reinforcement may improve the success rate.

Original languageEnglish (US)
Pages (from-to)2360-2366
Number of pages7
JournalAmerican Journal of Gastroenterology
Issue number11
StatePublished - Nov 1996
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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