Gastroenterology - Biofeedback/Pelvic Floor Re-training

This leaflet has 3 aims:

1. To help you become better informed and more involved in your care.
2. To give a general overview of biofeedback/pelvic floor retraining
3. To answer some of the questions commonly asked about the procedure.

If you have any questions, access or communication needs such as an interpreter please contact the department stated on your appointment letter.

Reasonable adjustments will be considered for all disabled users of this service.

Please make sure that you read the following information CAREFULLY.

Your healthcare professional has requested that you undertake a course of biofeedback/pelvic floor retraining due to problems that you are experiencing with your bowels. The most common bowel problems that patients attend with are faecal incontinence, constipation, and difficulty opening their bowels. In some cases, a consultant may request biofeedback prior to surgery. These are just some of the reasons why people are referred for biofeedback.

When you come for your appointment, it would be helpful to us if you could bring a list of your medications with you.
 
If you have any heart or breathing problems/conditions, we would appreciate it if you could notify us of these conditions before you attend for your appointment.

What is biofeedback/pelvic floor retraining?

Biofeedback is also known as pelvic floor retraining. It is a series of appointments that are tailored to your symptoms. At each session, depending on your bowel complaint, we will discuss your progress as well as recording and assessing your muscle function in your back passage using a catheter which will be inserted into your rectum (bottom). We use many different techniques within pelvic floor retraining, and the professional that you see will use the techniques that are best suited to your particular symptoms and/or muscle problems.

Below are just some of the techniques used:

• Specific exercises to strengthen the muscles in the back passage
• Toileting position
• Bearing down techniques
• Educational techniques, such as using the balloon catheter to mimic stool in the rectum
• Techniques to encourage the rectum to be able to hold more stool
• Other treatments that may help, such as certain medicines

How long will the sessions last and how many will I have?

Each session takes 30 minutes. We usually give 3-5 appointments in all, the first and last appointment tie in with your anorectal physiology appointments to avoid you having to make extra trips. On the first session we may book all the remaining sessions, but they are not set in stone, and you may not need all of them.

Reasonable adjustments will be considered for all disabled users of this service.

Will I need special medication, and will I be able to take my usual medication?

We do not ask you to take any medication prior to the sessions. We do not require bowel preparation, although if you have had a bowel action prior to the investigation you will find the sessions more comfortable.

You should continue with your usual medication; you do not need to stop any medication.

Is biofeedback/pelvic floor retraining painful?

The treatment should not cause you any pain. Occasionally people find it uncomfortable, but this will depend on your own symptoms.

Will I be able to ask questions?

You can ask questions at any time prior to, during the test and after the sessions.

What happens when the biofeedback/pelvic floor retraining is finished?

On the last session we will repeat certain parts of the anorectal physiology test that you had at the beginning so that we have pre and post results. The results of this will be sent to your hospital consultant by letter or report. You should hear from your consultant to attend for a follow up appointment to discuss your treatment and symptoms.

Benefits and Risks

The benefit of having this treatment is that it may help to improve your symptoms. Depending on the outcome of the treatment it will help your doctor to decide on your future management.

There are no known risks associated with biofeedback /pelvic floor retraining. There is a small risk of perforation as we use catheter in your back passage, but there have been no reported incidents. Some people find the positioning of the catheter uncomfortable, but this is quite normal.

There is no direct alternative to this therapy other than not going ahead with this therapy.

If you have any questions please contact the Department, contact details are on your appointment letter.

Smoking Policy

Northern Care Alliance operates a smoke free policy. To find out what this means for you, pick up the leaflets available at the hospital. For advice on stopping smoking contact 0161 212 4050.