What question did this study set out to answer?

To evaluate the effectiveness of virtually delivered biofeedback compared to in-person therapy for bowel dysfunction.

March 29, 2026

SRS78 - An analysis of virtually delivered biofeedback for bowel dysfunction and implications for future practice

Key Points

To evaluate the effectiveness of virtually delivered biofeedback compared to in-person therapy for bowel dysfunction.
Conducted an equivalence study over 9 months.
Compared 254 patients undergoing virtual therapy with 221 patients treated in-person.
Analyzed treatment completion rates, stool frequency, and medication use in both groups.
Similar completion rates: 74% virtual vs 76% in-person.
In faecal incontinence, weekly stool frequency reduced similarly in both groups (3.3 vs 4.2).
In constipation, average stool frequency increased similarly (1.4 vs 2.2) in both groups.
Reduction in medication use was similar: 22% virtual vs 30% in-person for faecal incontinence.

Abstract

Abstract Introduction Biofeedback is an established therapy for faecal incontinence and chronic constipation, but, availability of services is limited and related to the need for face-to-face sessions at specialist units. The COVID-19 pandemic necessitated a move to virtual healthcare delivery. We report an equivalence study comparing virtual to in-person therapy. Methods Over a 9-month period consecutive patients undergoing virtual Biofeedback during the COVID-19 pandemic (n = 254, 84% women, mean age 41.4) were compared with a time-matched pre-pandemic group treated in-person (n = 221, 82% women, mean age 39.7). The two groups were similar in terms of aetiology, symptom type and severity. Results Treatment completion rates were similar in both groups (74 versus 76%, virtual versus in-person). In FI patients, there were similar reductions in mean weekly stool frequency in both groups (3.3 versus 4.2, ) and use of medications (22 versus 30%, ). In constipation patients there was similar increase in mean weekly stool frequency in both groups (1.4 versus 2.2, ) and similar reduction in medication use (24 versus 32%, ). Overal,l 58% versus 54% of patients () were discharged at treatment end. Conclusions Biofeedback therapy delivered virtually is an effective treatment option, representing a potentially more cost-effective option. Virtual biofeedback could reduce access inequality by opening the therapy to a geographically wider patient population. Further research is needed to identify subgroups who may need in-person therapy, allowing development of more streamlined pathways.

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