Department of Surgery, the Chinese University of Hong Kong, Shatin, Hong Kong.
California Medical Innovations Institute, San Diego, California, USA.
Clin Transl Gastroenterol. 2022 May 1;13(5):e00491. doi: 10.14309/ctg.0000000000000491.
Biofeedback therapy (BFT) is a well-known treatment for functional anorectal disorders. The effect of BFT was monitored in fecal incontinence (FI) patients with the Fecobionics test and with the conventional technologies, anorectal manometry (ARM) and balloon expulsion test (BET).
Studies were performed in 12 patients before and after 8 weeks of biofeedback training. The Fecal Incontinence Severity Index (FISI) score was obtained. Anal resting and squeeze pressures were measured before the bag was distended in the rectum until urge to defecate. Pressure recordings were made during Fecobionics evacuation.
BFT resulted in 24% reduction in FISI scores (P < 0.01). Seven patients were characterized as responders. Anal pressures, the urge-to-defecate volume, and defecatory parameters did not change significantly during BFT. For ARM-BET, the maximum anal squeeze pressure, the urge-to-defecate volume, and the expulsion time were lower after BFT compared with those before BFT (P < 0.05). For Fecobionics, the change in urge volume (r = 0.74, P < 0.05) and the change in defecation index (r = 0.79, P < 0.01) were associated with the change in FISI score. None of the ARM-BET parameters were associated with the change in FISI score. It was studied whether any pre-BFT data could predict treatment success. The Fecobionics expulsion duration and the defecation index predicted the outcome (P < 0.05). The defecation index had a sensitivity of 100% and a specificity of 72%. None of the ARM-BET parameters predicted the outcome (all P > 0.2).
Fecobionics was used as a tool to monitor the effect of BFT and proved better than conventional technologies for monitoring and predicting the outcome in the FISI score.
生物反馈疗法（BFT）是一种治疗功能性肛门直肠疾病的知名方法。通过 Fecobionics 测试和常规技术（肛门直肠测压术（ARM）和球囊排出试验（BET））监测生物反馈治疗（BFT）对粪便失禁（FI）患者的疗效。
对 12 例患者进行了 8 周生物反馈训练前后的研究。获得粪便失禁严重程度指数（FISI）评分。在直肠充盈袋之前测量肛门静息和收缩压，直到有排便冲动。在 Fecobionics 排空期间进行压力记录。
BFT 使 FISI 评分降低了 24%（P<0.01）。7 例患者被认为是有反应者。在 BFT 期间，肛门压力、排便冲动量和排便参数没有明显变化。对于 ARM-BET，与 BFT 前相比，BFT 后最大肛门收缩压、排便冲动量和排空时间较低（P<0.05）。对于 Fecobionics，排便冲动量的变化（r=0.74，P<0.05）和排便指数的变化（r=0.79，P<0.01）与 FISI 评分的变化相关。ARM-BET 参数均与 FISI 评分的变化无关。研究了任何 BFT 前的数据是否可以预测治疗效果。Fecobionics 排空时间和排便指数预测了结果（P<0.05）。排便指数的灵敏度为 100%，特异性为 72%。ARM-BET 参数均未预测结果（均 P>0.2）。
Fecobionics 被用作监测 BFT 效果的工具，并且比常规技术在监测和预测 FISI 评分中的结果方面更有效。
