Biofeedback Therapy

Biofeedback is a behavioral treatment method that involves retraining the bowel. It is most commonly applied to patients suffering from gas and fecal incontinence and chronic constipation. The main purposes of this treatment are to relax the pelvic floor muscles and anal sphincter during defecation, to ensure rectoanal coordination and to improve rectal sensitivity. It is a behavioral treatment method that includes re-education of the intestine, such as teaching the correct straining movements that have been learned incorrectly and explaining in detail exercises to strengthen the anus muscles. Along with these techniques, diet and lifestyle required for healthy bowel functions, anal and pelvic floor muscle exercises, verbal biofeedback treatments and visual/auditory biofeedback treatments using computer programs can also be applied. Approximately 6 months after biofeedback treatment, anorectal manometer was used again The patient is evaluated and his/her current condition is compared with the pre-treatment values.

The patient is placed in a supine position with knees bent. An anal probe that measures pressure is placed into the anus. Additionally, a probe is placed around the anus to measure the strength of the muscles. The patient is seated on a mock toilet-shaped chair so that he can see the computer on which special programs are installed. The technique and logic of the program are explained, and the patient is asked to contract and relax the anal muscles. The first test is called 'threshold test' and during this, maximum contraction and minimum relaxation are measured. Following this, the patient is instructed to squeeze his anus as much as he can and the 'tolerant squeeze pressure' is measured. Certain changes are made depending on the patient, and the anus is frequently contracted for 5 seconds and relaxed for 10 seconds, a total of 8 times.
Although each treatment session lasts approximately 30-45 minutes, the ideal number of treatment sessions varies from patient to patient, with an average of 4-6 sessions to strengthen the anus muscles and the defecation process, accompanied by these exercises.

Patients are advised that failure may occur from time to time, and failure to achieve complete results from an exercise once should not be considered a failure and should be repeated, especially after meals, which is the period when the gastrocolic reflex is stimulated.
The chance of success in cases such as gas and poop incontinence is around 50%, and it is reported that 60-90% success is achieved with biofeedback treatment in constipation.

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