However, we must not forget that, despite having these functional tests, the results are not valid if they are not interpreted by an expert who can understand the pathophysiology of the ano-rectal region with a good systematic study including listening to the patient and conducting a thorough examination.
For both constipation and incontinence, it is essential to make the most accurate diagnosis possible for the treatment to be effective and to obtain the desired results.
Many cases of constipation involve obstructive defecation due to poor coordination of the anoperineal muscles during evacuation. In these cases, the use of laxatives or alimentary fibre has little effect.
It has been proven that in order to correct this impaired evacuation the most effective method is re-education through biofeedback techniques. This is the reason why our treatment protocol includes these re-educating techniques before surgery in order to reduce postoperative pain generated by defecation in surgical patients (haemorrhoids, anal fissure, fistula…) who have been diagnosed with this kind of constipation.
If the problem is loss of continence, we always start with a proper dietary regulation, accompanied, if appropriate, by drug treatment.
To improve continence, rehabilitation of muscles at the anal sphincter and pelvic floor using biofeedback is the most widely-used conservative technique, either used alone or combined with surgery when necessary.