title: Biofeedback therapy for bowel dysfunction following low anterior resection.
abstract: Faecal incontinence and intractable constipation after low anterior resection (LAR) can be refractory to expectancy and appropriate anti-diarrhoeal or laxative medications. The efficacy of anorectal biofeedback therapy (BF) in this clinical situation was prospectively assessed. Eleven patients [5 men and 6 women; mean age 64.8 years; standard error of the mean (SEM) 3.3 years] had either faecal incontinence or intractable constipation which did not settle with medications, for at least 6 months [mean 33.3 (SEM 6.1) months] after LAR. They all underwent 4 sessions of outpatient BF. Assessment was by continence questionnaire and anorectal physiology tests, which were administered before and after BF. In 6 of 6 incontinent patients, weekly incontinent episodes were decreased [14.8 (SEM 2.1] before, 1.8 (SEM 0.8) after; P < 0.05) and anti-diarrhoeal drug requirements were reduced (needed in 6 before, 0 after; P < 0.05) after BF. In the 5 intractible constipation patients, the weekly stool frequency was improved [3 (SEM 0.5) before, 8.9 (SEM 1.6) after; P < 0.05] after BF. There were no significant changes in the anorectal physiology parameters after BF. At a mean follow-up of 12.9 (SEM 1.6) months, there were no regressions or complications. BF is a safe option for refractory bowel dysfunction following LAR.
authors.affiliation: Department of Colorectal Surgery, Singapore General Hospital, Singapore.
authors.forename: Y H
authors.initials: YH
authors.lastname: Ho
authors.forename: M
authors.initials: M
authors.lastname: Tan
mesh_terms: D001003:Anal Canal / Q000503:physiopathology; D001676:Biofeedback, Psychology; D003106:Colon / Q000601:surgery*; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D011795:Surveys and Questionnaires