Results of biofeedback therapy for fecal incontinence in children with encopresis and following surgery for anorectal malformations.
BACKGROUND
Some children with fecal incontinence respond to biofeedback therapy. However, whether they can achieve fecal continence posttherapeutically has not been clarified. We studied the serial results of biofeedback therapy and discuss the necessity of providing repeated biofeedback therapy at home.


METHODS
Nineteen children with encopresis underwent one session of biofeedback therapy. Seven of 15 children with fecal incontinence that developed after surgery for anorectal malformations underwent three to eight sessions of biofeedback therapy; the remaining 8 underwent one (mean, 2.9) session only. The patients were hospitalized for one session of biofeedback therapy. To monitor the clinical outcome of intervention, we used serial score assessments from three months to two years posttherapeutically.


RESULTS
Seventeen of 19 (90 percent) patients with encopresis showed clinical improvement after one session of therapy (P < 0.0001). Six months after treatment, however, six of ten (60 percent) patients with encopresis reported recurrent fecal incontinence after one therapeutic session. Clinical improvement was noted in 5 of 15 (33 percent) patients who had fecal incontinence after surgery for anorectal malformations. All five patients showed clinical improvement from six months to two years after several sessions of biofeedback therapy (P < 0.05).


CONCLUSIONS
Biofeedback therapy is effective in most children with encopresis and in some children with anorectal malformations. However, some patients need repeated sessions of biofeedback therapy to achieve fecal continence. Therefore, a new portable biofeedback apparatus for the treatment of fecal incontinence at home may be helpful.
Hibi
Masahito
M
Division of Surgery, Children's Research Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Iwai
Naomi
N
Kimura
Osamu
O
Sasaki
Yasunari
Y
Tsuda
Tomoki
T
D000293:Adolescent; D001003:Anal Canal / Q000002:abnormalities* / Q000601:surgery; D001676:Biofeedback, Psychology / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004065:Digestive System Abnormalities / Q000150:complications / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005242:Fecal Incontinence / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D011183:Postoperative Complications / Q000628:therapy*; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012720:Severity of Illness Index; D016896:Treatment Outcome