RANDOMIZED TRIAL OF BIOFEEDBACK TRAINING FOR ENCOPRESIS

Aims-To evaluate biofeedback training in children with encopresis and the effect on psychosocial function. Design-Prospective controlled ran domised study. Patient interventions-A multimodal treatment of six wee ks. Children were randomised into two groups. Each group received diet ary and toilet advice, enemas, oral laxatives, and anorectal manometry . One group also received five biofeedback training sessions. Main out come measures-Successful treatment was defined as less than two episod es of encopresis, regular bowel movements, and no laxatives. Psychosoc ial function after treatment was assessed using the Child Behaviour Ch ecklist. Results-Children given laxatives and biofeedback training had higher success rates than those who received laxatives alone (39% v 1 9%) at the end of the intervention period. At 12 and 18 months, howeve r, approximately 50% of children in each group were successfully treat ed. Abnormal behaviour scores were initially observed in 35% of childr en. Most children had improved behaviour scores six months after treat ment. Children with an initial abnormal behaviour score who were succe ssfully treated had a significant improvement in their behavioural pro files. Conclusions-Biofeedback training had no additional effect on th e success rate or behaviour scores. Psychosocial problems are present in a subgroup of children with encopresis. The relation between succes sful treatment and improvement in behavioural function supports the id ea that encopresis has an aetiological role in the occurrence and main tenance of behavioural problems in children with encopresis.