A Cochrane review [Abstract] 1 included 21 studies with a total of 1 371 subjects. All studies but one investigated children with functional faecal incontinence. The synthesis of data from nine trials showed higher rather than lower rates of persisting problem up to 12 months when biofeedback was added to conventional treatment (OR 1.11 CI 95% 0.78 to 1.58). This result was consistent with that of two trials with longer follow-up (OR 1.31 CI 95% 0.80 to 2.15). In one trial the adjunct of anorectal manometry to conventional treatment did not result in higher success rates in chronically constipated children (OR 1.40 95% CI 0.72 to 2.73 at 24 months).
In one small trial the addition of behaviour modifications to laxative therapy was associated with a marked reduction in children's soiling episodes at both the three month (OR 0.14 CI 95% 0.04 to 0.51) and the 12 month assessment (OR 0.20 CI 95% 0.06 to 0.65).
Comment: The quality of evidence is downgraded by study limitations (inadequate or unclear allocation concealment), and by imprecise results (few patients and outcome events).
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