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Long-term effects of transabdominal electrical stimulation in treating children with slow-transit constipation
Leanne C Y Leong1, Yee Ian Yik, Anthony G Catto-Smith
1Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia.
Insights
Transcutaneous electrical stimulation (TES) shows promise for treating slow-transit constipation (STC) in children. While one-third experienced lasting improvement, others saw symptom recurrence within six months.
Area of Science:
- Pediatric Gastroenterology
- Neuromodulation Therapies
- Functional Gastrointestinal Disorders
Background:
- Slow-transit constipation (STC) is a challenging condition in children.
- Current treatments for STC have limitations.
- Transcutaneous electrical stimulation (TES) is an emerging therapeutic option.
Purpose of the Study:
- To evaluate the long-term efficacy of transcutaneous electrical stimulation (TES) in children with slow-transit constipation (STC).
- To determine if TES treatment for STC leads to sustained improvements in bowel function and symptoms.
Main Methods:
- A randomized controlled trial involving 39 children with STC treated with TES for 1-2 months.
- Long-term follow-up of 30 patients (mean 3.5 years post-treatment) via questionnaires.
- Outcomes assessed using statistical methods including confidence intervals and paired t-tests.
Main Results:
- 73% of children reported perceived improvement with TES.
- Sustained improvement (>2 years) was observed in 33%, while 25-33% experienced recurrence within 6 months.
- Significant improvements noted in soiling (75%), abdominal pain (59%), and continence scores (81%).
Conclusions:
- Transcutaneous electrical stimulation (TES) demonstrates potential as a treatment for pediatric STC.
- TES can lead to significant short- and long-term benefits for a subset of children with STC.
- Further research may optimize TES protocols for sustained symptom relief in STC.
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.
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