Electrical stimulation for faecal incontinence in adults

Faecal incontinence (inability to control bowel movements or leaking stool from the anus) can be a very embarrassing and socially restricting problem. There are many possible causes, including childbirth damage to the muscles which control bowel movements. Direct electrical stimulation of these muscles has been used to try to help people with faecal incontinence. The review found that there is not enough evidence from trials to judge whether electrical stimulation is helpful. Exercises and electrical stimulation used in the anus may be more helpful than vaginal exercises for women with faecal incontinence after childbirth.

Authors' conclusions: 

At present, there are insufficient data to allow reliable conclusions to be drawn on the effects of electrical stimulation in the management of faecal incontinence. There is a suggestion that electrical stimulation may have a therapeutic effect, but this is not certain. Larger, more generalisable trials are needed.

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Background: 

Faecal incontinence is a particularly embarrassing and distressing condition with significant medical, social and economic implications. Electrical stimulation has been used with apparent success in the treatment of faecal incontinence. However, standards of treatment are still lacking and the magnitude of alleged benefits has yet to be established.

Objectives: 

To determine the effects of electrical stimulation for the treatment of faecal incontinence in adults.

Search strategy: 

We searched the Cochrane Incontinence Group Specialised Trials Register (searched 13 March 2007) and reference lists of potentially eligible articles.

Selection criteria: 

All randomised or quasi-randomised trials evaluating electrical stimulation in adults with faecal incontinence.

Data collection and analysis: 

Two reviewers assessed the methodological quality of potentially eligible trials and independently extracted data from the included trials. A wide range of outcome measures were considered.

Main results: 

Four eligible trials with 260 participants were identified. Findings from one trial suggest that electrical stimulation with anal biofeedback and exercises provides more short-term benefits than vaginal biofeedback and exercises for women with obstetric-related faecal incontinence. Another study found contradictory results, with no added benefit from electrical stimulation over biofeedback and exercises alone. Although all trials report that patient's symptoms are generally improved, it is not clear that this is the effect of electrical stimulation. No further conclusions could be drawn from the data available.

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