Effect of Anorectal Biofeedback on Encopresis in School Aged Girls After Sexual Assault

Effect of Anorectal Biofeedback on Encopresis in School Aged Girls After Sexual Assault

Females who have been sexually abused anally, have a disturbed anorectal motility. They have an increased resting pressure at the lower part of the anal canal. When their rectum is suddenly distended, they tend not to have an initially increased pressure in the anal canal, and the recto-anal inhibitory reflex is markedly decreased amplitude which is caused by reflex contraction of the pelvic floor during the relaxation of the internal anal sphincter.

The cause of fecal incontinence after sexual abuse is the improper functioning of anal sphincter muscles, as a result of their damage and/or neurological changes including the disturbance perception of sensory stimuli from the anal canal. Biofeedback therapy using visual and verbal feedback techniques has emerged as an useful option in managing fecal incontinence and levator ani syndrome. The goal of biofeedback training is to improve bowel function by restoring a normal pattern of defecation.

Inclusion Criteria:

• absent anal reflex,
• skin trifles around the anus,
• funnel shaped anus
• medically stable and able to follow instructions

Exclusion Criteria:

• sexual transmitted disease
• any medical condition that affect the anus potentially such as Crohn's disease,
• severe chronic constipation,
• myotonic dystrophy