Application Of Biofeedback And Electrical Stimulation Therapy In Spina Bifida Occulta Children With Functional Constipation Or Non-retentive Fecal Incontinence

ObjectiveTo evaluate the efficacy of biofeedback and electrical stimulation therapy in children with functional constipation(FC) or non-retentive fecal incontinence(NRFI).MethodsThirty four FC children and twenty one NRFI children underwent conventional treatment,including oral laxatives,high-fibre diet,and toilet training.Among those children who were unresponsive to conventional treatment,15 FC and 9 NFRI children were treated by biofeedback and electrical stimulation therapy.All children were evaluated with plain X-ray fihns,neurophysiological study,colonic transit test,EMG and anorectal manometry sinmltaneously before and after treatment.ResultsOf the 55 children who received conventional treatment for at least two months, 22 children(40%) recovered according to the clinical recovery standard,and 5 improved significantly.All 24 children who received biofeedback and electrical stimulation therapy reported symptomatic improvements.Nineteen children(79.2%) recovered,and five children had moderate improvement after treatment.Comparing to the children who recovered after the conventional treatment,the children who received the biofeedback and electrical stimulation therapy had longer duration of symptoms(3.1±2.9 years vs.2.0±1.2 years),and had significantly more deranged anorectal function,especially vector volumes,rectal sensory threshold and latency of pudendo-anal reflex.After biofeedback and electrical stimulation therapy,the anal vector volume during contractions,and the EMG amplitude at rest & during contraction, showed significant improvements(p＜0.05).ConclusionsThe biofeedback with electrical stimulation therapy is suitable for improvement of the clinical outcome and physiological measurements in FC children or NRFI children.