Biofeedback Treatment for Fecal Incontinence

Biofeedback is a process by which an individual learns to control a bodily function that is not ordinarily perceived to be under the control of the individual. Fecal incontinence is one of the few indications for which biofeedback is considered to be clinically effective. The technique is designed to improve the threshold of conscious rectal sensation and to coordinate external anal sphincter contraction with rectal distension, two mechanisms that are frequently abnormal in patients with fecal incontinence. Biofeedback therapy is always preceded by a diagnostic evaluation that includes manometric determination of the thresholds of rectal sensation, internal anal sphincter relaxation, and external anal sphincter contraction in response to rectal distension. Subsequent to biofeedback training, patients are instructed to practice external sphincter contraction exercises several times daily and to contract the sphincter whenever they sense rectal distension or an urge to defecate. Most reports concerning biofeedback have employed the technique as originally described or with slight modifications.