Fecobionics assessment of the effect of position on defecatory efficacy in normal subjects

Chen, Ssu-Chi; Futaba, Kaori; Leung, Wing Wa; Wong, Carlos K. H.; Mak, Terrence; Ng, Simon; Gregersen, Hans

doi:10.1007/s10151-021-02439-2

Cited by 10 publications

(11 citation statements)

References 31 publications

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“…Fecobionics provides a new bionics concept to study anorectal physiology. Technological validation and data on normal subjects have been reported previously ( 11 – 13 , 30 , 31 ). Small-scale clinical studies have been performed in patients with FI, constipation, and low anterior resection syndrome ( 14 – 17 ).…”

Section: Discussionmentioning

confidence: 89%

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Futaba

Chen

Leung

et al. 2022

Clin Transl Gastroenterol

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INTRODUCTION: Biofeedback therapy (BFT) is a well-known treatment for functional anorectal disorders. The effect of BFT was monitored in fecal incontinence (FI) patients with the Fecobionics test and with the conventional technologies, anorectal manometry (ARM) and balloon expulsion test (BET). METHODS:Studies were performed in 12 patients before and after 8 weeks of biofeedback training. The Fecal Incontinence Severity Index (FISI) score was obtained. Anal resting and squeeze pressures were measured before the bag was distended in the rectum until urge to defecate. Pressure recordings were made during Fecobionics evacuation. RESULTS:BFT resulted in 24% reduction in FISI scores (P < 0.01). Seven patients were characterized as responders. Anal pressures, the urge-to-defecate volume, and defecatory parameters did not change significantly during BFT. For ARM-BET, the maximum anal squeeze pressure, the urge-to-defecate volume, and the expulsion time were lower after BFT compared with those before BFT (P < 0.05).For Fecobionics, the change in urge volume (r 5 0.74, P < 0.05) and the change in defecation index (r 5 0.79, P < 0.01) were associated with the change in FISI score. None of the ARM-BET parameters were associated with the change in FISI score. It was studied whether any pre-BFT data could predict treatment success. The Fecobionics expulsion duration and the defecation index predicted the outcome (P < 0.05). The defecation index had a sensitivity of 100% and a specificity of 72%. None of the ARM-BET parameters predicted the outcome (all P > 0.2). DISCUSSION:Fecobionics was used as a tool to monitor the effect of BFT and proved better than conventional technologies for monitoring and predicting the outcome in the FISI score.

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Section: Discussionmentioning

confidence: 89%

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Futaba

Chen

Leung

et al. 2022

Clin Transl Gastroenterol

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“…Another potential limitation is that the study was done on an Asian population. However, the subjects were accustomed to defecating in seating position rather than squatting and to the best of our knowledge, no study have shown major differences in anorectal function across human races 21 . Furthermore, the patients had relatively mild FI.…”

Section: Discussionmentioning

confidence: 93%

“…We are seeking to change the approach to anorectal functional testing with the overall goal to provide mechanistic understanding of defecation using a simulated stool named Fecobionics 16 – 21 . It integrates BET and ARM.…”

Section: Introductionmentioning

confidence: 99%

Fecobionics characterization of female patients with fecal incontinence

Futaba

Chen

Leung

et al. 2022

Sci Rep

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Defecatory disorders including fecal incontinence (FI) are diagnosed on the symptom pattern supplemented by anorectal manometry (ARM), the balloon expulsion test (BET), and endo-anal ultrasonography. In this study, we used a simulated stool named Fecobionics to study distinct defecation patterns in FI patients using preload-afterload diagrams and to provide comparative data on defecation indices (DIs) between passive and urge incontinent patients. All subjects had Fecobionics, endo-anal ultrasonography and ARM-BET done. The Fecobionics bag was distended in rectum until urge in 37 female patients (64.1 ± 1.5 yrs) and a group of normal subjects (NS, 12F, age 64.8 ± 2.8 yrs). Rear-front pressure (preload-afterload) diagrams and DIs were compared between groups. The FISI score in the patients was 8.6 ± 0.6. The NS did not report FI-related symptoms. All patients and NS defecated Fecobionics and ARM-BET within 2 min. The urge volume was 46.1 ± 3.6 and 35.3 ± 5.9 mL in the FI and normal groups (P > 0.1). The expulsion duration was 14.8 ± 2.4 and 19.8 ± 5.1 s for the two groups (P > 0.1). The preload-afterload diagrams demonstrated clockwise loops that clearly differed between the FI subtypes and NS. The DIs showed profound difference between patients and NS. Fecobionics data showed higher correlation with symptoms in FI patients than ARM-BET. Fecobionics obtained novel pressure signatures in subtypes of FI patients and NS. Fecobionics provides DI data that cannot be obtained with ARM-BET.

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“…By distending the anal sphincter, anal acoustic reflectometry and the anal barostat can assess the integrity and distensibility of the anal sphincter barrier 93–97 . A fecobionic silicon bag that resembles the consistency of normal stool has pressure and motion sensors that record pressures, anorectal angles, and expulsion velocity during defecation 98,99 …”

Section: Methodsmentioning

confidence: 99%

“…[93][94][95][96][97] A fecobionic silicon bag that resembles the consistency of normal stool has pressure and motion sensors that record pressures, anorectal angles, and expulsion velocity during defecation. 98,99 The incremental utility of these devices for understanding the pathogenesis or guiding the management of FI or DD remains to be established.…”

Section: Pressure Measurement In the Posterior Distal Pressure Zonementioning

confidence: 99%

Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test

Bharucha

Basilisco

Malcolm

et al. 2022

Neurogastroenterology Motil

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Anorectal manometry (ARM) is a sophisticated technique that quantifies several aspects of the complex and multifactorial mechanisms that regulate defecation and continence. 1 ARM records contractility and tone of the internal (IAS) and external anal sphincters (EAS); rectal sensitivity and compliance; the reflex relaxation of the IAS in response to rectal distension; the reflex contraction of the EAS in response to cough or Valsalva maneuver; and the dynamic changes of rectal and anal pressures during simulated evacuation. The technological advances of ARM and other techniques that assess colonic and anorectal functions (e.g., high-resolution colonic manometry and magnetic resonance imaging [MRI] proctography) have enhanced our understanding of the physiology of defecation and continence and related disorders. Anorectal manometry and the rectal balloon expulsion test are recommended initial tests for diagnosing DD in patients who have

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Fecobionics assessment of the effect of position on defecatory efficacy in normal subjects

Cited by 10 publications

References 31 publications

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Fecobionics characterization of female patients with fecal incontinence

Review of the indications, methods, and clinical utility of anorectal manometry and the rectal balloon expulsion test

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