Portable biofeedback apparatus for treatment of anal sphincter dystonia in childhood soiling and constipation

Abstract

Biofeedback is an effective treatment for anal sphincter dysfunction in many cases of childhood constipation and soiling. Conventional methodologies centre on clinic-based manometric apparatus but are compromised by equipment being thinly available and practice sessions often infrequent. To counter these shortcomings, we have designed a portable anorectal biofeedback apparatus (the Easograph) for domiciliary use. It can be lent to families, enabling carers to mediate what is an intrinsicially sensitive procedure. In this paper, we provide a technical description of the device which is based on an inexpensive pressure transducer. Casework experience suggests it is reliable in operation and readily understood by users. In a pilot study of eight patients treated with the apparatus, five achieved bowel continence after lifelong soiling in one to eight weeks of daily practice. We believe this is an innovative approach that has good potential for treating faecal retentive and expulsive disorders in childhood associated with poor anal sphincter control.