Biofeedback Therapy for Incontinence in a Post-Duhamel Hirschsprung Patient: A Case Report.

Fecal incontinence is a recognized but underreported postoperative complication in patients with Hirschsprung disease (HD) Retentive fecal incontinence may result from stool retention in the Duhamel pouch, altered rectal sensation, or dyssynergic defecation. We report the use of biofeedback therapy in a 17-year-old male with a history of HD and total colonic aganglionosis (TCA), who underwent a Duhamel pull-through in infancy and later developed recurrent fecal soiling and constipation. Clinical examination demonstrated stool retention with preserved perianal sensation and sphincter tone, consistent with retentive fecal incontinence Following eight sessions of biofeedback therapy (BFT), his Revised Fecal Incontinence Score (RFIS) improved from 16/20 to 1/20, with complete symptom resolution.