Pelvic floor rehabilitation for defecation disorders

  • R. Bocchini
  • G. Chiarioni
  • E. Corazziari
  • F. Pucciani
  • F. Torresan
  • P. Alduini
  • G. Bassotti
  • E. Battaglia
  • F. Ferrarini
  • F. Galeazzi
  • C. Londoni
  • P. Rossitti
  • P. Usai Satta
  • L. Iona
  • S. Marchi
  • G. Milazzo
  • D. F. Altomare
  • R. Barbera
  • A. Bove
  • C. Calcara
  • L. D’Alba
  • M. De Bona
  • F. Goffredo
  • G. Manfredi
  • G. Naldini
  • M. C. Neri
  • L. Turco
  • F. La Torre
  • A. P. D’Urso
  • I. Berni
  • M. A. Balestri
  • N. Busin
  • C. Boemo
  • M. Bellini
Review Article


Pelvic floor rehabilitation is frequently recommended for defecation disorders, in both constipation and fecal incontinence. However, the lack of patient selection, together with the variety of rehabilitation methods and protocols, often jeopardize the results of this approach, causing difficulty in evaluating outcomes and addressing proper management, and above all, in obtaining scientific evidence for the efficacy of these methods for specific indications. The authors represent different gastroenterological and surgical scientific societies in Italy, and their aim was to identify the indications and agree on treatment protocols for pelvic floor rehabilitation of patients with defecation disorders. This was achieved by means of a modified Delphi method, utilizing a working team (10 members) which developed the statements and a consensus group (15 members, different from the previous ones) which voted twice also suggesting modifications of the statements.


Defecation disorders Biofeedback Guidelines 


Author contributions

Authors and coauthors, Consensus members: All of them participated in study concept and design, data collection, provided critical revisions to manuscript drafts and approved the final version of the manuscript; therefore all should be regarded as collaborators for indexing purposes.


No support whatsoever has been granted.

Compliance with ethical standards

Conflict of interest

None conflict of interest to be declared.

Ethical approval

As consensus review this paper does not contain any studies involving human participants performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • R. Bocchini
    • 1
  • G. Chiarioni
    • 2
    • 3
  • E. Corazziari
    • 4
  • F. Pucciani
    • 5
  • F. Torresan
    • 6
  • P. Alduini
    • 7
  • G. Bassotti
    • 8
  • E. Battaglia
    • 9
  • F. Ferrarini
    • 10
  • F. Galeazzi
    • 11
  • C. Londoni
    • 12
  • P. Rossitti
    • 13
  • P. Usai Satta
    • 14
  • L. Iona
    • 15
  • S. Marchi
    • 16
  • G. Milazzo
    • 17
  • D. F. Altomare
    • 18
  • R. Barbera
    • 19
  • A. Bove
    • 20
  • C. Calcara
    • 21
  • L. D’Alba
    • 22
  • M. De Bona
    • 23
  • F. Goffredo
    • 24
  • G. Manfredi
    • 25
  • G. Naldini
    • 26
  • M. C. Neri
    • 27
  • L. Turco
    • 28
  • F. La Torre
    • 29
  • A. P. D’Urso
    • 30
  • I. Berni
    • 31
  • M. A. Balestri
    • 32
  • N. Busin
    • 33
  • C. Boemo
    • 34
  • M. Bellini
    • 35
  1. 1.Gastroenterology UnitMalatesta Novello Private HospitalCesenaItaly
  2. 2.RFF Division of GastroenterologyUniversity of VeronaVeronaItaly
  3. 3.Division of Gastroenterology and HepatologyUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of GastroenterologyIstituto Clinico HumanitasMilanItaly
  5. 5.Department of Surgery and Translational MedicineUniversity of FlorenceFlorenceItaly
  6. 6.Department of Medical and Surgical Sciences, St. Orsola-Malpighi HospitalUniversity of BolognaBolognaItaly
  7. 7.Gastroenterology and Endoscopy UnitSan Luca HospitalLuccaItaly
  8. 8.Gastroenterology and Hepatology Section, Department of MedicineUniversity of Perugia Medical SchoolPerugiaItaly
  9. 9.Gastroenterology and Endoscopy UnitCardinal Massaia HospitalAstiItaly
  10. 10.Endoscopy UnitSan Clemente Private HospitalMantuaItaly
  11. 11.Gastroenterology Unit, Department of Surgery, Oncology and GastroenterologyUniversity of PaduaPaduaItaly
  12. 12.Gastroenterology and Endoscopy UnitASST “Maggiore”CremaItaly
  13. 13.Gastroenterology UnitS. Maria della Misericordia HospitalUdineItaly
  14. 14.Gastroenterology UnitG. Brotzu HospitalCagliariItaly
  15. 15.Early Rehabilitation DepartmentS. Maria della Misericordia HospitalUdineItaly
  16. 16.Gastrointestinal Unit, Departmentt. of General SurgeryUniversity of PisaPisaItaly
  17. 17.U.O.Lungodegenza e Medicina, Ospedale Vittorio Emanuele IIISalemiItaly
  18. 18.Department of Emergency and Organ Transplantation (DETO) and Interdepart mental Research Center for Pelvic Floor Dysfunction (CIRPAP)University Aldo MoroBariItaly
  19. 19.San Giuseppe Multimedica HospitalMilanItaly
  20. 20.Gastroenterology and Endoscopy Unit, Department of GastroenterologyA. Cardarelli HospitalNaplesItaly
  21. 21.Gastroenterology UnitSSVD Gastroenterologia, Ospedale SS TrinitàBorgomaneroItaly
  22. 22.Gastroenterology and Digestive Endoscopy UnitSan Giovanni-Addolorata HospitalRomeItaly
  23. 23.Gastroenterology and Endoscopy UnitFeltre HospitalFeltreItaly
  24. 24.Gastroenterology and Endoscopy UnitSan Camillo-Forlanini HospitalRomeItaly
  25. 25.Department of Gastroenterology and Digestive EndoscopyCrema Hospital, ASST CREMACremaItaly
  26. 26.Proctological and Perineal Surgery UnitCisanello University HospitalPisaItaly
  27. 27.Gastroenterology UnitGeriatric Institute “Pio Albergo Trivulzio”MilanItaly
  28. 28.Department of Digestive PhysiopathologyHealte Center “Cittadella della Salute”LecceItaly
  29. 29.Department of Surgical SciencesUniversity “La Sapienza”, Policlinico Umberto IRomeItaly
  30. 30.Policlinico MorgagniCataniaItaly
  31. 31.Rehabilitation DepartmentSan Luca HospitalLuccaItaly
  32. 32.Proctological and Perineal Surgery UnitCisanello University HospitalPisaItaly
  33. 33.Rehabilitation DepartmentVilla Igea Private HospitalForlìItaly
  34. 34.Early Rehabilitation DepartmentS. Maria della Misericordia HospitalUdineItaly
  35. 35.Gastrointestinal Unit, Department of General SurgeryUniversity of PisaPisaItaly

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