This single case study describes the successful application of pelvic floor exercise to the treatment of childhood encopresis. A 10-year-old boy with lifelong incontinence of faeces and anal sphincter hypotonia practised daily pelvic floor contractions by interrupting his urine flow mid-stream, the rationale for the regime being strengthening of the sphincter muscle and improvement of its voluntary operation. Benefits to bowel control were immediate and complete cleanliness was achieved in 9 weeks. Being non-intrusive, the exercise procedure may be more acceptable to some patients with anal sphincter flaccidity than balloon biofeedback. The likely mechanism underlying the method is simultaneous contraction of the anorectal sphincter when the bladder sphincter is tensed.

A six-year-old girl with surgically corrected imperforate anus and chronic faecal soiling was successfully treated by biofeedback. A portable biofeedback machine using an anorectal balloon was constructed and lent to the patient’s mother who administered the treatment at home following instruction in the clinic. Faecal incontinence was replaced by normal bowel evacuation habits after four weeks of the procedure. The effect was durable at least until follow-up at three months. Positive spin-offs were observed. The reversal of the child's encopresis suggested neuromuscular intactness of the anorectalregion despite the congenital malformation. Biofeedback probably compensated for an earlier learning fault. Domiciliary, parent-mediated biofeedback therapy is a cost-effective procedure and may be widely applicable to suitable patients within the population of children with primary expulsive and retentive bowel control disorders.