Portable biofeedback apparatus for treatment of anal sphincter dystonia inchildhood soiling and constipation

Biofeedback is an effective treatment for anal sphincter dysfunction in man y cases of childhood constipation and soiling. Conventional methodologies c entre on clinic-based manometric apparatus but are compromised by equipment being thinly available and practice sessions often infrequent. To counter these shortcomings, we have designed a portable anorectal biofeedback appar atus (the Easograph) for domiciliary use. It can be lent to families, enabl ing carers to mediate what is an intrinsicially sensitive procedure. In thi s paper, we provide a technical description of the device which is based on an inexpensive pressure transducer. Casework experience suggests it is rel iable in operation and readily understood by users. In a pilot study of eig ht patients treated with the apparatus, five achieved bowel continence afte r lifelong soiling in one to eight weeks of daily practice. We believe this b an innovative approach that has good potential for treating faecal reten tive and expulsive disorders in childhood associated with poor anal sphinct er control.