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Neuromodulation. 2016 Jul;19(5):515-21. doi: 10.1111/ner.12451. Epub 2016 Jun 13.

Home Transcutaneous Electrical Stimulation Therapy to Treat Children With Anorectal Retention: A Pilot Study.

Author information

1
Gut Motility Laboratory, Douglas Stephens Surgical Research Group, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.
2
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
3
Division of Paediatric Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
4
Service De Chirurgie Pediatrique, Departement Medico-Chirurgical De Pediatrie, Centre Hospitalier Universitaire Vaudois, Switzerland.
5
Department of Urology, Royal Children's Hospital, Melbourne, VIC, Australia.

Abstract

AIM:

As transcutaneous electrical stimulation (TES) increased defecation in children and adults with Slow-Transit Constipation (STC), we performed a pilot study to test if TES can improve symptoms (defecation and soiling) in children with chronic constipation without STC and transit delay in the anorectum.

METHODS:

Children with treatment-resistant constipation presenting to a tertiary hospital had gastrointestinal nuclear transit study (NTS) showing normal proximal colonic transit and anorectal holdup of tracer. TES was administered at home (1 hour/day for 3 months) using a battery-powered interferential stimulator, with four adhesive electrodes (4 × 4 cm) connected so currents cross within the lower abdomen at the level of S2-S4. Stimulation was added to existing laxatives. Daily continence diary, and quality-of-life questionnaires (PedsQL4.0) were compared before and after TES.

RESULTS:

Ten children (4 females: 5-10 years, mean 8 years) had holdup in the anorectum by NTS. Nine had <3 bowel motions (BM)/week. After three months TES, defecation frequency increased in 9/10 (mean 0.9-4.1 BM/week, p = 0.004), with 6/9 improved to ≥3 BM/week. Soiling reduced in 9/10 from 5.9 to 1.9 days/week with soiling, p = 0.004. Ten were on laxatives, and nine reduced/stopped laxative use. Quality-of-life improved to within the normal range.

CONCLUSION:

TES improved symptoms of constipation in >50% of children with treatment-resistant constipation with isolated holdup in the anorectum. Further studies (RCTs) are warranted in these children.

KEYWORDS:

chronic constipation; interferential current; neuromodulation; paediatric

PMID:
27293084
DOI:
10.1111/ner.12451
[Indexed for MEDLINE]

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