Is a new biofeedback therapy effective for fecal incontinence in patients who have anorectal malformations?
OBJECTIVE
The authors devised computerized equipment for use in the biofeedback therapy in the management of fecal continence after surgery for anorectal malformations.


METHODS
The therapy was used for two to eight sessions in 14 children (11 who had high-type anomalies and three who had intermediate-type anomalies). The ages ranged 5 to 14 years. A control group of 17 children, aged 5 to 11 years, who had encopresis, was also treated with the same biofeedback therapy.


RESULTS
Clinical improvement was noted in 5 of the 14 (36%) children who had fecal incontinence, and in 15 of the 17 children (88%) who had encopresis. Both in patients who had fecal incontinence and in those who had encopresis, anal resting pressures were not affected by biofeedback therapy. Furthermore, the anal resting pressure in children who had fecal incontinence was significantly lower than that in children who had encopresis. However, anorectal manometry showed that the biofeedback therapy improved voluntary sphincter function and rectal sensation in both groups.


CONCLUSIONS
Biofeedback therapy appears to be effective in most children who have encopresis whose sphincter function is intact, and in some children who have fecal incontinence after surgery for anorectal malformations.
Iwai
N
N
Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Japan.
Iwata
G
G
Kimura
O
O
Yanagihara
J
J
D000293:Adolescent; D001003:Anal Canal / Q000002:abnormalities* / Q000502:physiology; D001676:Biofeedback, Psychology / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004065:Digestive System Abnormalities / Q000150:complications; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008365:Manometry; D012007:Rectum / Q000002:abnormalities*; D012677:Sensation