Rehabilitation role in childhood defecation problem.

Abstract

Childhood constipation is a common problem in medicine. One of the most common causes of the symptom is the muscles of the pelvic floor and external anal sphincter cannot relax due to the fear of painful defecation. The patients withhold their feces which results in functional fecal retention. Furthermore, encopresis or soiling develops from fecal retention. In order to treat this symptom, biofeedback is developed to train the muscles of the pelvic floor and external anal sphincter and encouraged in children and adults with functional constipation and fecal incontinence. Additionally, its rehabilitation includes pelvic floor muscle training, rectal balloon training, electrical stimulation and digital stimulation.

A summary of treatment methodologies and recent studies helpfully provide information regarding the benefits of these treatments in clinical practices. Recently, many randomized controlled trials have considered biofeedback training as an adjunctive therapy for childhood constipation. Also, pelvic floor muscle training is a basic treatment for fecal incontinence. Rectal balloon training, which enhances rectal sensation, strengthens the effect to the pelvic floor muscles training for fecal incontinence. So far, digital stimulation, despite being widely recommended among neurogenic bowel patients, has only been studied in term of its mechanism but without clinical correlations.