title: Biofeedback therapy for symptoms of bowel dysfunction following surgery for colorectal cancer.
abstract: BACKGROUND
  Following colorectal cancer (CRC) surgery, up to 60% of patients experience post-surgery bowel dysfunction (PSBD). This retrospective review aimed to evaluate biofeedback therapy with regard to patients' symptoms of fecal incontinence (FI) and stool frequency.
  
  
  METHODS
  Patients with symptoms including frequency, urgency, FI, incomplete evacuation, failure to respond to dietary, medication or standard pelvic floor exercises (≥ 6 months) underwent biofeedback therapy between 2003 and 2006. Patients attended 3-4 sessions 1 week apart incorporating: anorectal function assessment; Fecal Incontinence Quality of Life (FIQL) and severity questionnaires; suggested coping strategies; dietary advice; bowel, food and exercise diary training; relaxation breathing; evacuation techniques; anal and pelvic floor muscle exercises using computerized visual feedback; and were reassessed at a final session following 4 weeks of home practice.
  
  
  RESULTS
  Nineteen CRC PSBD patients [anterior resection (3); ultra-low anterior resection (10); segmental colectomy (2); and proctocolectomy (4)], mean age: 64.1 (95% CI: 47.0-81.3) years, participated. FIQL scales improved significantly for lifestyle, coping and embarrassment but not depression. Incontinence severity and number of bowel motions significantly decreased. Satisfaction with results of therapy was high. Subjective bowel control rating improved. FIQL scores further improved 2 years later.
  
  
  CONCLUSIONS
  The holistic biofeedback protocol for PSBD in CRC patients is successful in the short and medium term.
authors.affiliation: Faecal Incontinence Research Group, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, QLD, 4811, Australia. Lynne.Bartlett@my.jcu.edu.au
authors.forename: L
authors.initials: L
authors.lastname: Bartlett
authors.forename: K
authors.initials: K
authors.lastname: Sloots
authors.forename: M
authors.initials: M
authors.lastname: Nowak
authors.forename: Y-H
authors.initials: YH
authors.lastname: Ho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001676:Biofeedback, Psychology / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D003672:Defecation / Q000502:physiology; D005242:Fecal Incontinence / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome