Coordination Training for Fecal Incontinence

The aim of coordination training is to achieve a maximum voluntary squeeze in less than 1 to 2 seconds after inflation of the rectal balloon and to control the reflex anal relaxation by consciously contracting the sphincter muscles. This maneuver mimics the arrival of stool in the rectum and prepares the patient to react appropriately by using the appropriate muscle group. With each balloon insufflation, patients are asked to signal when they have perceived rectal distention and react to this distention by promptly contracting the PFM and maintaining this contraction without increasing intraabdominal pressure; this maneuver is performed while the patient observes changes on the visual display. The key element is to condition the external anal sphincter responses to improve the squeeze profile and the ability to respond to small volumes of rectal distention.

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