Pelvic Floor Muscle Strengthening Using Biofeedback for Treatment of Fecal Incontinence in a Patient with Multiple Sclerosis

Case Report

Dawn Sandalcidi

Background: Fecal incontinence (FI) affects a large and growing number of US adults, particularly women 65 years of age and older. Although rectal prolapse is rare, up to 75% of individuals with rectal prolapse have FI. FI can profoundly affect people's quality of life and daily functioning. 
Method and findings: Conservative therapy, medications, dietary fiber intake, and pelvic floor muscle strengthening, is considered the first-line approach. This case report features a 70-year-old woman with FI due to rectal prolapse, whose efforts to control her FI are complicated by muscle weakness due to multiple sclerosis. The multiple sclerosis affects her ability to strengthen her pelvic floor muscles, which is a key component for the treatment of FI. The case report follows her introduction to a novel pelvic floor muscle training system that uses a Smartphone application to allow the patient to observe the strength and duration of her pelvic muscle contractions and a web portal to allow the physical therapist to monitor the patient's progress.
Conclusions: A course of PFMT with real-time biofeedback can combine motivation and reassurance toward the goal of symptom relief and control of FI. In this case, an older woman with reduced voluntary muscle control was able to use a smart phone app driven device to improve pelvic floor muscle strength and control. Demonstrating the benefit for patients with fecal incontinence and rectal prolapse.

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