TREATMENT OF FECAL INCONTINENCE BY OPERANT CONDITIONING.

The recto-sphincteric reflexes are neurally mediated responses of the anal sphincters to rectal distension. Though these responses are reflexes in the normal subject, they can be brought under voluntary control in certain kinds of patients. Training of such control can be used to treat various disorders of bowel function. The motor activity of the anal sphincters can be measured by monitoring pressure changes in appropriately placed balloons. Pressures are electrically transduced and recorded. Some patients with disorders of bowel function can be trained to control this activity. In response to rectal distension the internal anal sphincter relaxes and the external anal contracts. Disfunction of these sphincters is associated with various motor disorders of the bowel. Some such patients can be trained to develop more normal sphincteric responses, and thereby they can achieve significant, sustained therapeutic benefits.