Development of an adolescent biofeedback service to manage bowel dysfunction in younger patients

Abstract

Bowel dysfunction, including constipation and faecal incontinence, is common, debilitating and associated with psychological problems, exacerbated by social stigma. It can usually be managed effectively with thorough symptom assessment, followed by a personalised treatment plan of conservative, evidence-based and non-invasive interventions, including biofeedback therapy. St Mark's Hospital in Northwest London provides a dedicated biofeedback service with a multidisciplinary, multimodal and behavioural approach. Bowel dysfunction is common in paediatric patients, including adolescents, who were an increasing proportion of St Mark's patients. Adolescence is a period of intense physical, psychological and social development, as young people are faced with hormonal, emotional and sexual pressures. St Mark's established an adolescent biofeedback service to provide dedicated treatment, education and support. This considered the impact of peer pressure, eating disorders and school life, as well as encouraging long-term co-ordinated transition to adult care. Clinicians used comfortable and comprehensible language, with new adolescent-friendly literature based on stages of development. Parental involvement was carefully considered and encouraged where appropriate. This clinic should improve bowel function and quality of life in younger patients, as well as reduce relapse in later life.