BIOFEEDBACK THERAPY FOR FECAL INCONTINENCE

Abstract

Operant conditioning offers a new therapeutic modality for fecal incontinence. Experience with biofeedback therapy in 6 male and 6 female patients (ages 12-78 yr) is presented. Incontinence was associated with a surgical procedure in 6 patients and with a medical condition in 6 patients. Rectosphincteric manometry was performed using a 3 balloon technique, with 1 balloon positioned in the rectum as a distending stimulus and the others at the internal and external sphincters. Pressure responses to measured volumes of rectal distention were displayed on a polygraph. Rectosphincteric reflexes and sensory thresholds for rectal distention were determined. Patients were then encouraged to elevate sphincter pressures while observing their manometric responses. Follow-up of 10-96 wk showed 10 patients had good responses, with complete continence in 6 patients. Nine of 10 responders required only 1 treatment session. Operant conditioning is a valuable technique in properly selected patients with an 80% probability of success.