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Functional changes after physiotherapy in fecal incontinence

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Physiotherapy is a common treatment option in patients with fecal incontinence. Although physiotherapy may result in relief of symptoms, to what extent improvement is associated with changes in anorectal function is still unclear.

Aim

The aim of the present study was to investigate prospectively how anorectal function changes with physiotherapy and whether these changes are related to changes in fecal incontinence score.

Methods

Consenting consecutive patients (n=266) with fecal incontinence (91% women; mean age, 59 years) underwent anorectal manometry, anal and rectal mucosal sensitivity measurements, and rectal capacity measurement at baseline and after nine sessions of standardized pelvic floor physiotherapy. These findings were compared with changes in Vaizey incontinence score.

Results

On follow-up 3 months after physiotherapy, squeeze pressure (p=0.028), as well as urge sensation threshold (p=0.046) and maximum tolerable volume (p=0.018), had increased significantly. The extent of improvement was not related to age, duration of fecal incontinence, menopause, and endosonography findings. All other anorectal functions did not change. An improvement in the Vaizey score was moderately correlated with an increase in incremental squeeze pressure (r=0.14, p=0.04) and a decrease in anal mucosal sensitivity threshold (r=0.20, p=0.01).

Conclusions

Physiotherapy improves squeeze pressure, urge sensation, and maximum tolerable volume. However, improved anorectal function does not always result in a decrease in fecal incontinence complaints.

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Acknowledgements

This work was supported by a grant from The Netherlands Organization for Health Research and Development ZON-MW (grant 945-01-013, 2001).

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Authors and Affiliations

  1. Department of Radiology, Academic Medical Center, G1-228, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Annette C. Dobben, Maaike P. Terra & Jaap Stoker

  2. Pelvic Care Unit Maastricht, University Hospital Maastricht, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands

    Bary Berghmans

  3. Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Marije Deutekom & Patrick M. M. Bossuyt

  4. Department of Gastroenterology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    Guy E. E. Boeckxstaens

  5. Department of Colorectal Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    Lucas W. M. Janssen

Authors
  1. Annette C. Dobben
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  2. Maaike P. Terra
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  3. Bary Berghmans
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  4. Marije Deutekom
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  5. Guy E. E. Boeckxstaens
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  6. Lucas W. M. Janssen
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  7. Patrick M. M. Bossuyt
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  8. Jaap Stoker
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Corresponding author

Correspondence to Annette C. Dobben.

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Dobben, A.C., Terra, M.P., Berghmans, B. et al. Functional changes after physiotherapy in fecal incontinence. Int J Colorectal Dis 21, 515–521 (2006). https://doi.org/10.1007/s00384-005-0049-6

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  • DOI: https://doi.org/10.1007/s00384-005-0049-6

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