Biofeedback

Abstract

Biofeedback is a conservative treatment that is widely recognized to be, along with lifestyle modifications and pharmaceutical support, one of the first-line approaches in fecal incontinence. Although data in the literature are controversial with regard to its real benefit, and studies lack standardized protocols, this technique is relatively easy, readily accepted by patients, has no side-effects, and is of great help for patients' physical and psychological well-being. Compliance, cognitive capacities, and major sphincteric lesions are the limiting steps of successful therapy. So far, little is known about predictive factors of good outcome in patients with fecal incontinence. Future placebo-controlled randomized studies are needed to better evaluate pelvic floor retraining in individuals who do not respond to advice/education alone, and to evaluate sensory retraining in incontinent patients. Outcomes should include standardized measures, validated quality-of-life questionnaires, and long-term assessment of therapeutic success. © 2010 Springer-Verlag Milan.