Anal sphincter biofeedback and pelvic floor exercises for faecal incontinence in adults--a systematic review.
BACKGROUND
Faecal incontinence is a common health care problem. Biofeedback is extensively used in clinical practice to treat faecal incontinence.


OBJECTIVE
To systematically review and evaluate the evidence from clinical studies on the effectiveness of biofeedback as a treatment for faecal incontinence in adults.


METHODS
A systematic literature search was undertaken using electronic databases, with review of the retrieved references.


RESULTS
The search identified 46 studies published in English using biofeedback to treat adults complaining of faecal incontinence. Those studies included a total of 1364 patients. Of those studies with adequate data, 275 out of 566 patients (49%) were said to be cured of symptoms of faecal incontinence following biofeedback therapy and 617 out of 861 (72%) patients were reported to be cured or improved. Studies varied in the method of biofeedback used, criteria for success and the outcome measures used. Only eight of the 46 studies employed any form of control group.


CONCLUSIONS
The data suggest that biofeedback and exercises help a majority of patients with faecal incontinence. However, methodological variation, lack of controls and a lack of validated outcome measures are problems in evaluating these results.
Norton
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C
Physiology Unit, St Mark's Hospital, Harrow, UK. csnorton@aol.com
Kamm
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MA
D000328:Adult; D001003:Anal Canal / Q000502:physiology*; D001676:Biofeedback, Psychology / Q000502:physiology; D002986:Clinical Trials as Topic; D005081:Exercise Therapy; D005242:Fecal Incontinence / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010388:Pelvis; D016896:Treatment Outcome