Treatment of Fecal Incontinence and Functional Defecation Disorders Using Non-instrumental Biofeedback
Background. Rehabilitation and re-education using instrumental anorectal biofeedback are the main treatment of anorectal functional disorders producing incontinence and outlet obstructed defecation. These treatments imply intubation of patient and several sessions of treatment leading to high consumption of resources and costs.

Hypothesis. A cognitive intervention based on original audiovisual programs developed specifically for the management of anorectal functional disorders is effective in correcting anorectal function disorders that cause fecal incontinence and evacuation disorders.

Aim. To prove In two different protocols (fecal incontinence and dyssinergic defecation) the efficacy of specifically developed non-instrumental biofeedback techniques.

Selection criteria. Patients with fecal incontinence and altered sphincter function and patients with outlet obstructed evacuation referred for biofeedback treatment.

Intervention. In separate studies (incontinence and dyssynergic defecation) patients will be randomized into biofeedback and placebo groups. One session of either biofeedback or placebo intervention will be performed at the beginning of the intervention period followed by reinforcement phone call after 2 months in incontinence and 7 days in dyssinergic defecation studies. A final visit for outcome assessment will be performed after 6 months in the incontinence study and after 4 weeks in the dyssinergic defecation study.

Biofeedback: patients will be taught to control anal and abdominal muscular activity by providing instructions using original video supports. Patients will be instructed to perform the same exercises daily at home in Schedule times.

Placebo: alternative exercises will be taught by watching commercial videos. Patients will be instructed to perform the same exercises at home following the same schedule as patients in biofeedback treatment.
- EligibilityCriteria: Inclusion Criteria:  Incontinence studies  Patients who have at least 4 episodes of fecal incontinence during the last 14 days. Patients able to follow instructions and attend study visits.  Dyssinergic defecation studies  Patients with constipation who present less than 3 complete spontaneous bowel movements per week and/or who have Bristol 1 or Bristol 2 type stools in more than 25% of the bowel movements in the 2 weeks prior to the study Patients able to follow instructions and attend study visits.  Exclusion Criteria:  Patients with organic digestive diseases such as inflammatory bowel disease, celiac disease, gastro-duodenal ulcer... Patients with neurological diseases (spinal cord injury, multiple sclerosis, Parkinson's disease). Patients with previous of active colon and/or rectal cancer. Patients with rectal fistula. Patients with rectal prolapse. Patients with total colectomy. Patients who have had any radiation to the pelvis in the last month. - HealthyVolunteers: No - Gender: All - MinimumAge: 18 Years - MaximumAge: 75 Years - StdAgeList: Adult, Older Adult