Anal sphincter biofeedback and pelvic floor exercises for faecal incontinence in adults - a systematic review

Background: Faecal incontinence is a common health care problem. Biofeedbac k is extensively used in clinical practice to treat faecal incontinence. Aim: To systematically review and evaluate the evidence from clinical studi es on the effectiveness of biofeedback as a treatment for faecal incontinen ce in adults. Methods: A systematic literature search was undertaken using electronic dat abases, with review of the retrieved references. Results: The search identified 46 studies published in English using biofee dback to treat adults complaining of faecal incontinence. Those studies inc luded a total of 1364 patients. Of those studies with adequate data, 275 ou t of 566 patients (49%) were said to be cured of symptoms of faecal inconti nence following biofeedback therapy and 617 out of 861 (72%) patients were reported to be cured or improved. Studies varied in the method of biofeedba ck used, criteria for success and the outcome measures used. Only eight of the 46 studies employed any form of control group. Conclusions: The data suggest that biofeedback and exercises help a majorit y of patients with faecal incontinence. However, methodological variation, lack of controls and a lack of validated outcome measures are problems in e valuating these results.