Treatment of postsurgery bowel dysfunction: biofeedback therapy

Abstract

Following surgical procedures such as partial colectomy, total colectomy with ileorectal anastomosis, restorative proctocolectomy, or low anterior anastomosis, altered bowel habits and function may have adverse long-term effects on health-related quality of life. Symptoms of postsurgery bowel dysfunction include loose stools, frequent defecation, rectal urgency, fecal incontinence, and difficult or incomplete evacuation. The Anorectal Physiology Clinic at The Townsville Hospital, Queensland, Australia, offers a treatment program for postsurgery bowel dysfunction that combines behavioral strategies and pelvic floor muscle training using biofeedback techniques. The behavioral strategies include education, support and coping measures, and advice about diet, fluid intake, medication, and exercise discussed in a previous article. This article describes biofeedback-assisted pelvic floor muscle training, including techniques for relaxation and effective bowel evacuation, and exercises for pelvic floor muscle strengthening. Biofeedback is also used to modify rectal sensitivity and assist with anorectal coordination training, in order to alleviate stool frequency and urgency. We believe that behavioral strategies and pelvic floor muscle training are complementary components of the holistic treatment program.