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Improvement of Refractory Ulcerative Proctitis With Sacral Nerve Stimulation
Jérémy Brégeon1, Michel Neunlist, Céline Bossard
1*INSERM UMR 913, Institut des maladies de l'appareil digestif, CHU de Nantes, Université de Nantes †Laboratoire d'anatomie pathologique, CHU de Nantes, Nantes, France.
Journal of Clinical Gastroenterology
|May 2, 2015
Summary
Sacral nerve stimulation (SNS) improved refractory proctitis symptoms and rectal barrier function in a patient. This suggests SNS may offer benefits beyond fecal incontinence treatment.
Area of Science:
- Gastroenterology
- Neurology
- Immunology
Background:
- Sacral nerve stimulation (SNS) is established for anal incontinence.
- Emerging evidence suggests SNS may benefit conditions involving intestinal barrier dysfunction.
- This study investigated SNS for refractory proctitis.
Observation:
- A patient with refractory proctitis experienced mucus/blood discharge, pain, and incontinence despite immunosuppressants.
- Sacral nerve stimulation was initiated for fecal incontinence.
- The impact of SNS on proctitis disease activity and rectal barrier function was assessed.
Findings:
- SNS significantly reduced fecal incontinence and proctitis disease activity scores within 3 weeks.
- Endoscopic and histologic scores improved, alongside decreased rectal barrier permeability.
- Junctional protein mRNA expression increased transiently, with sustained clinical and histologic improvement over 18 months.
Implications:
- Sacral nerve stimulation demonstrates potential therapeutic benefits for proctitis.
- SNS may be a viable treatment option for inflammatory bowel conditions beyond fecal incontinence.
- Further research into SNS for intestinal barrier disorders is warranted.
