Fecal Incontinence

Enck's critical review8 summarized a total of 13 clinical studies published between 1974 and 1990 using biofeedback therapy for the treatment of fecal incontinence. He reported that weighing the number of patients included into each study yields an overall success rate of 79.8%. Despite the wide variety in almost all criteria used to compare these studies, the therapy outcome is homogenous, ranging between 50% to 90%. In a review of 14 biofeedback studies performed between 1988 and 1997, Rao et al.9 reported that 40% to 100% of patients were improved. The mechanism by which training effects are achieved is controversial. Some have argued that the most important ingredient is sensory discrimination training in which patients are taught to recognize and respond to increased intrarectal pressure or to squeeze more quickly in response to rectal distention. Others believe that biofeedback works primarily by strengthening the external anal sphincter muscles. On one hand, sensations consistently improve with biofeedback. Because this improvement occurs rapidly, it is likely associated with relearning of neurophysiologic patterns that are essentially intact but not in use because of faulty sensation. When the muscles are weak but sensation is intact, symptom reduction would depend on changing muscle strength through an extended and well-designed exercise protocol. In general, most experts believe that all components are useful and that the treatment program should be customized to each patient depending on the underlying dysfunction.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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