Biofeedback, explained simply
What is biofeedback, and is it right for you?
No medical background needed. This page walks through what biofeedback actually is, what the Ins&Outs program looks like week by week, and how to tell whether it's likely to help your particular symptoms.
What is anorectal biofeedback?
Your rectum and the muscles around your anus work as a two-part system: one part pushes, one part holds. Most bowel problems come down to those two parts not coordinating properly and because you can't see or feel these muscles working, it's very hard to fix that on your own.
Biofeedback uses a small, soft sensor placed in the rectal area, connected to a screen or app. It shows you - in real time - exactly what those muscles are doing: whether they're tightening when they should be relaxing, or not generating enough pressure to push properly.
With that live feedback, you practise correcting the pattern, the same way you'd use a mirror to fix your posture. Over several sessions, your brain and body learn the new pattern - and eventually you can do it without the device at all.
Biofeedback is safe. It's a well-established, evidence-based therapy with no significant side effects. It's not a drug and it's not surgery, it's a training process for muscles you already have.
Isn't this the same as pelvic floor exercises?
Not quite. General pelvic floor exercises strengthen one broad group of muscles. Anorectal biofeedback is specific to the rectum and anal sphincters, and it targets coordination as much as strength - training the muscles to work in the right order, at the right time. That's why it needs a sensor and feedback, rather than just repetition.
Which one sounds like you?
Biofeedback treats two very different-feeling problems, using two different training approaches. Choose the one closer to your experience.
Constipation & incomplete emptying
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Dyssynergic defecation
This is when the muscles around your anus don't relax when you try to go, sometimes they even tighten instead, or your abdominal muscles can't generate enough coordinated push. The result is stool that's difficult to pass, even if your diet and fibre intake are fine.
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Fewer than 3 bowel movements a week
Excessive straining, every time
Feeling like you haven't fully emptied
Needing to manually help stool out
Hard, painful stool, bloating, or anal pain
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Your training pathway
Correct sitting posture and breathing on the toilet
Learning to push from your abdomen, not by straining
Learning to feel and trigger anal muscle relaxation
Coordinating the push and the relax together
Reducing excessive straining over time
Practising the technique for real, sitting on the toilet
Locking in stool consistency and a reliable routine
Faecal incontinence
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Faecal incontinence
This is the accidental passing of poo or gas. It shows up in a few different ways: feeling the urge but not making it in time (urge incontinence), no warning at all (passive incontinence), or leakage/staining after an otherwise normal bowel motion (seepage).
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Sudden urgency with little or no warning
Leakage when passing wind
Accidents you weren't aware of until after the fact
Underwear staining after a normal motion
Avoiding travel, exercise, or social plans because of it
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Your training pathway
Building strength in the muscle that holds stool in
Building endurance so it can hold for longer
Isolating that muscle, without straining your stomach
Timing drills, so the muscle responds on cue
If needed, re-training your body's warning signals
Real-world strategies for urgent moments (pacing, pre-emptive squeezing, riding out an urge)
Your program at a glance
Every program starts with a consult so we can confirm biofeedback is the right fit, then follows a structured, personalised progression - whether at our private clinic, over Telehealth, or self-guided at home.
Before week 1
Consult
30-min private call. We review your history and confirm biofeedback is suitable for you.
Week 1
Lean & baseline
Bowel health education, device setup, and a baseline reading of your current muscle patterns.
Week 2
Personalised training
Exercises tailored to your baseline results, guided by live feedback.
Week 3
Practice in real life
We remove the training wheels, practising the same technique on the toilet, without relying on the screen.
Week 4
Reassess & maintain
Repeat the baseline test to confirm improvement, then agree a simple plan to keep it up long-term.
Is biofeedback right for me?
Biofeedback helps a specific set of problems very well. It's not the right first step for everyone — some symptoms need a doctor's assessment before starting.
Usually a good fit
Chronic constipation with straining or a feeling of incomplete emptying
Leakage of stool or gas, with or without warning
You've already tried diet, fibre, or laxatives without lasting success
You want a non-surgical, non-drug option
You're comfortable using an app or device at home, or would prefer guided in-clinic sessions
Talk to a doctor first
Rectal bleeding or unexplained weight loss
A new change in bowel habit that hasn't been checked
Severe or worsening pelvic/rectal pain, or suspected blockage
Significant prolapse, anal fissure, or a suspected sphincter injury
Significant neurological disease, or difficulty using a toilet/device independently
None of this means biofeedback definitely isn't for you it means these need a health professional's eyes first. This is exactly what the $29 consult is for.
What results can I expect?
Biofeedback is one of the most evidence-backed treatments for these conditions, in both clinic and at-home settings [1-8].
75-90%
long-term symptom relief across published outcomes
4-6 weeks
typical program length, ~10 min/day at home
0
significant side effects reported
1. Rao et al. 2015. Neurogastroenterology & Motility, 27(5), pp.594-609.; 2. Chiarioni et al. 2006. Gastroenterology 130: 657–64.; 3. Bartlett et al. 2011. Dis Colon Rectum 54: 846–56.; 4. Chiarioni et al. 2010 Gastroenterology 138: 1321–9.; 5. Rao et al. 2018. The lancet Gastroenterology & hepatology, 3(11), pp.768-777.; 6. Xiang et al. 2021. Neurogastroenterology & Motility, 33(11), p.e14168.; 7. Bartlett et al. 2015. Journal of Clinical Gastroenterology, 49(5), pp.419-428.; 8. Zhou et al. 2024. Plos one, 19(9), p.e0311134.
Common questions
Does it hurt?
1
No. The sensor is small and soft. Most people describe the sensation as unusual at first, not painful.
Will I need the device forever?
2
No, the whole point of the program is to teach your body the correct pattern so you can eventually do it without any device at all. That's what the "practice in real life" week is for.
Can I do the entire program from home?
Yes. The Ins&Outs device is designed for self-guided home use, with optional Telehealth check-ins if you'd like clinical guidance along the way - you don't need to attend a clinic in person.
3
Is this confidential and private?
4
Yes. Consults are one-on-one and can be done entirely by phone or video. The device itself is designed for private, independent use at home.
What if the program doesn't work for me?
5
If you've purchased the device directly, it's covered by a 30-day money-back guarantee. If your consult suggests biofeedback isn't the right fit, we'll tell you plainly and point you toward what is.
Still not sure? That’s exactly what the consult is for
30 minutes, $29, no obligation. We'll talk through your symptoms and tell you honestly whether biofeedback, and which pathway, is right for you.