Turkish Journal of Physical Medicine and Rehabilitation 2005 , Vol 51 , Num 3
The Efficacy of Behavioral Modification Program and Pressure Biofeedback Method in Children with Encopresis Who Were Resistant to Standard Treatment Regimens
Çiğdem Tüzün 1 ,Canan Tıkız 2 ,Zeliha Ünlü 2 ,Erhun Kasırga 3
1 Celal Bayar Üniversitesi Tıp Fakültesi Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Manisa
2 Celal Bayar Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Manisa, Türkiye
3 Celal Bayar Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı, Manisa

Objective: The purpose of this study was to evaluate the efficacy of pressure biofeedback (BF) method as an adjunct to behavioral modification program on anorectal function and continence restoration in children with encopresis.

 

Materials and Methods: Eight children (6 boys and 2 girls) were enrolled in the study. During the first four weeks, behavioral modification program including toilet training, fiber rich diet and conditioning was applied. During the following four weeks, pressure BF training as an adjunct to the behavioral modification program was applied for 60 minutes, two times a week to the children with persistent fecal incontinence. Anorectal function and quality of life were assessed with manometric measurements, Wexner and Holschneider incontinence scoring systems, quality of life measurement and defecation diaries before and immediately after the BF treatment and at 1st month.

 

Results: Significant decrease in resting pressure was detected in manometric anal measurements immediately after the BF treatment and at 1st month (p<0.05). Although a rising trend was observed in maximum squeeze pressure, it did not reach to a statistical significance. A decrease in sensory threshold and an increase in time for half of the maximal squeeze pressure were observed in the manometric pressure measurements (p<0.005). A significant improvement in the quality of life and in the severity of incontinence was also found immediately after the BF treatment and at 1st month.

 

Conclusion: Our study suggests that the application of pressure BF method as an adjunct to behavioral modification program may significantly improve anorectal functions and quality of life in children with encopresis who were resistant to standard treatment regimens. 

Keywords : Encopresis, fecal incontinence, biofeedback, childhood