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

• Published in: Journal of pediatric surgery Vol. 46; no. 12; pp. 2309 - 2312
• Main Authors: Leong, Leanne C.Y, Yik, Yee Ian, Catto-Smith, Anthony G, Robertson, Val J, Hutson, John M, Southwell, Bridget R
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2011
• Subjects: Abdominal Pain - etiology; Adolescent; Child; Chronic Disease; Chronic treatment-resistant constipation; Constipation - complications; Constipation - physiopathology; Constipation - therapy; Defecation; Encopresis; Encopresis - etiology; Fecal Incontinence - etiology; Fecal soiling; Female; Follow-Up Studies; Gastrointestinal Transit; Home Nursing; Humans; Laxatives - therapeutic use; Male; Patient Satisfaction; Pediatrics; Recurrence; Surgery; Surveys and Questionnaires; Transabdominal electrical stimulation; Transcutaneous Electric Nerve Stimulation; Chronic treatment-resistant constipation; Fecal soiling; Transabdominal electrical stimulation; Encopresis
• ISSN: 0022-3468; 1531-5037
• 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.