Gastroenterology - Biofeedback Therapy

Biofeedback is a process of conditioning the mind as well as the body to regulate body functions. It is a useful and non-invasive therapy free of side effects for the treatment of incontinence (inability to hold gas and stool in the back passage) and certain types of constipation (being unable to go to the toilet). Problems with passing stools (such as incontinence and constipation) can occur as a result of disorders affecting the muscles of the anal sphincter (control muscle) and pelvic floor.

The back passage (anus) has two rings of muscle around it; the inner and external sphincter muscles. The inner ring is an involuntary muscle, which should be closed at all times, except when you are trying to open your bowels. The outer ring is a voluntary muscle, which you can tighten up to close more firmly if you have urgency or diarrhoea. Both muscles wrap around the back passage. The muscles can become weak because of general wear and tear and injury during childbirth, surgery etc. If you have weak anal sphincter muscles and cannot squeeze enough to hang on, you will feel urgency and may leak gas, liquid or even solid stool. On the other hand, if your anal sphincter muscles are overactive and they contract instead of relax on bearing down when trying to open your bowels, it leads to a type of constipation called obstructed defaecation.

Benefits

Biofeedback therapy is useful for the treatment of both stool incontinence (bowel contents leaking from the back passage) as well as constipation due to dysfunctional defaecation. It is essentially carried out by feeding back certain biological signal- like pressure or electrical signals produced by the activity of the anal sphincter muscles. This is done using a computer so that you can modify their function. During the training session, you will be asked to squeeze your anal sphincter muscles. You will also be asked to bear down on an inflated balloon placed in the rectum. You will then be able to see the pressure or electrical signals from the anal sphincter. These signals may suggest that the muscles are either weak or overactive.

Looking at these signals on the screen, you will be taught, through repeated verbal reinforcements by the therapist, how to relax the sphincter muscles in the case of dysfunctional defaecation. Similarly, if the muscles are weak, you will be taught how to exercise them properly to make them stronger. You will also be given written instructions to continue with these exercises at home. Following the initial session the need for up to four further biofeedback therapy sessions will be assessed and appointments arranged. Each session will last between one to one and a half hours.

These exercises will help to strengthen the muscles in your back passage. You may need to exercise regularly for several months before the muscles gain their full strength. As the sphincter muscles become stronger, you will notice that your ability to control bowel contents improves. Once you have regained control of your bowel, do not forget your exercises. Continue to do them for a few times each day to ensure that the problem does not come back.

Risks

There are no side effects with these exercises.

Alternatives

Sphincter repair surgery for faecal incontinence is available, but it is undertaken only in special situations.

For further enquiries contact the Unit on 01706 517422 or the booking team on 01706 906788.