Department of Colorectal Surgery, Singapore General Hospital, Singapore.
ANZ J Surg. 2023 May;93(5):1262-1266. doi: 10.1111/ans.18131. Epub 2022 Oct 29.
Faecal incontinence (FI) is a debilitating condition which reduces quality of life (QOL). Conservative management with education, pelvic floor exercise and pharmacological agents are first-line treatment. Following which, biofeedback therapy (BFT) is recommended. Although well described in the West, existing literature on its efficacy in Asian populations remains sparse. The primary aim of our study is to evaluate the efficacy of BFT in improvement of symptoms, QOL and overall satisfaction in our Asian population.
Patients with moderate FI in Singapore General Hospital between 2012 and 2016 were enrolled. Rockwood FI quality of life scale (FIQL) and Wexner scale were used to evaluate QOL across four domains, and symptom severity respectively. They were scored at baseline and again after four sessions of BFT, with an additional overall satisfaction score (OSS).
A total of 137 patients were included. Mean age was 62 years and 72.3% were female. Majority demonstrated improvement in Wexner score (68.6%) and FIQL (65%). Sixty-five patients (47.4%) reported improvement in both. Positive correlation was found between Wexner score and OSS (r = 0.206), and Wexner score and FIQL across all four domains. Only one FIQL domain-coping/behaviour, showed statistically significant correlation with OSS (r = 0.263).
BFT is effective in our Asian population in both symptom reduction and improving QOL. Wexner score demonstrated low correlation with FIQL and OSS-suggesting that FI requires a multi-dimensional approach beyond symptom treatment, of which ability to cope appears crucial. BFT, consistent with the biopsychosocial model, shows benefit in this regard.
粪便失禁（FI）是一种使人虚弱的疾病，会降低生活质量（QOL）。教育、盆底运动和药物等保守治疗是一线治疗方法。在此之后，推荐使用生物反馈治疗（BFT）。尽管在西方有很好的描述，但关于其在亚洲人群中的疗效的现有文献仍然很少。我们研究的主要目的是评估 BFT 在改善我们亚洲人群的症状、QOL 和总体满意度方面的疗效。
我们招募了 2012 年至 2016 年期间在新加坡综合医院患有中度 FI 的患者。使用 Rockwood FI 生活质量量表（FIQL）和 Wexner 量表评估四个领域的 QOL 和症状严重程度。在基线和 BFT 的四个疗程后再次进行评分，并增加总体满意度评分（OSS）。
共纳入 137 例患者。平均年龄为 62 岁，72.3%为女性。大多数患者的 Wexner 评分（68.6%）和 FIQL（65%）都有所改善。65 例患者（47.4%）报告两者均有改善。Wexner 评分与 OSS 之间存在正相关（r=0.206），Wexner 评分与 FIQL 所有四个领域均存在正相关。只有 FIQL 领域的应对/行为与 OSS 呈统计学显著相关（r=0.263）。
BFT 在我们的亚洲人群中对症状减轻和提高 QOL 都有效。Wexner 评分与 FIQL 和 OSS 的相关性较低-表明 FI 需要一种多维方法来治疗症状，其中应对能力似乎至关重要。BFT 符合生物心理社会模式，在这方面显示出益处。
