Long-term effects of transabdominal electrical stimulation in treating children with slow-transit constipation

J Pediatr Surg. 2011 Dec;46(12):2309-12. doi: 10.1016/j.jpedsurg.2011.09.022.

Abstract

Aims: Transcutaneous electrical stimulation (TES) was used to treat children with slow-transit constipation (STC) for 1 to 2 months in a randomized controlled trial during 2006 to 2008. We aimed to determine long-term outcomes, hypothesizing that TES produced sustained improvement.

Methods: Physiotherapists administered 1 to 2 months of TES to 39 children (20 minutes, 3 times a week). Fifteen continued to self-administer TES (30 minutes daily for more than 2 months). Mean long-term follow-up of 30 of 39 patients was conducted using questionnaire review 3.5 years (range 1.9-4.7 years) later. Outcomes were evaluated by confidence intervals or paired t test.

Results: Seventy-three percent of patients perceived improvement, lasting more than 2 years in 33% and less than 6 months in 25% to 33%. Defecation frequency improved in 30%. Stools got wetter in 62% after stimulation and then drier again. Soiling improved in 75% and abdominal pain in 59%. Laxative use stopped in 52%, and 43% with appendicostomies stopped washouts. Soiling/Holschneider continence score improved in 81% (P = .0002). Timed sits switched to urge-initiated defecations in 80% patients. Eighty percent of relapsed patients elected to have home stimulation.

Conclusion: TES holds promise for STC children. Improvement occurred in two thirds of children, lasting more than 2 years in one third, whereas symptoms recurred after 6 months in one third of children.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Abdominal Pain / etiology
  • Adolescent
  • Child
  • Chronic Disease
  • Constipation / complications
  • Constipation / physiopathology
  • Constipation / therapy*
  • Defecation
  • Encopresis / etiology
  • Fecal Incontinence / etiology
  • Female
  • Follow-Up Studies
  • Gastrointestinal Transit*
  • Home Nursing
  • Humans
  • Laxatives / therapeutic use
  • Male
  • Patient Satisfaction
  • Recurrence
  • Surveys and Questionnaires
  • Transcutaneous Electric Nerve Stimulation*

Substances

  • Laxatives