MANAGEMENT OF FAECAL INCONTINENCE BY PELVIC FLOOR MUSCLE EXERCISE, FARADIC ELECTROSTIMULATION AND BEHAVIOURAL TRAINING - A Case Study

Abstract

The existing methods of faecal incontinence management have met with mixed success. Recently, there has been increased interest in pelvic floor contraction and electrostimulation ofthe pelvicfloor muscles. Thispaperpresentsa casestudy ofa 1O-year old girl with a diagnosis of faecal incontinence secondary to sexual assault. Before the commencement of treatment, the strength of the pelvicfloor muscles wasassessedusingapelvicfloor muscle grading system. The severity and frequency of incontinence, as well as the subjects's attitude to incontinence were also assessed with the aid of a questionnaire. The assessment was followed by six weeks of physiotherapy treatment with pelvic floor muscle strengthening exercises, faradic electrostimulation and behavioural training. The frequency of treatment was twice a week for six weeks (12 sessions). The outcome of the treatment revealed no remarkable improvement for the first and second weeks of treatment. At the third week of treatment, however, an increase in the pelvic floor muscle strength from 2/5 to 3/5 was observed, the severity of incontinence was reduced from 'soiling the outer clothing' to 'soiling the underwear '. The time between meal and defecation also increased from 2 minutes to 20 minutes. By the end ofthe 4th week, the frequency of incontinence was fllrther reduced. By then, the subject no 10nRer perceived the incontinence as a major problem but as a minor inconvenience, since she could now hold on for 60 minlltes after eating before defecating. The outcome ofthis study has demonstrated the efficacy of pelvic floor exercises, faradic electrostimulation and behavioural training as an effective method oftreatment for faecal incontinence.