Bilateral transcutaneous tibial nerve stimulation for chronic constipation

Area of Science:

• Gastroenterology
• Neurology
• Medical Devices

Background:

• Chronic constipation is a prevalent condition often refractory to conventional treatments.
• Distal neuromodulation, including percutaneous methods, can influence colonic propulsion.
• Transcutaneous tibial nerve stimulation (TTNS) presents a noninvasive, cost-effective alternative for neuromodulation.

Purpose of the Study:

• To evaluate the efficacy of noninvasive bilateral transcutaneous tibial nerve stimulation (TTNS) in patients with chronic constipation.
• To assess the impact of TTNS on quality of life and symptom severity in chronic constipation.

Main Methods:

• Eighteen patients with chronic constipation refractory to conservative therapy participated.
• Daily 30-minute bilateral TTNS was self-administered at home for six weeks.
• Primary outcome: change in Patient Assessment of Constipation Quality of Life (PAC-QoL) score; secondary outcomes: PAC-SYM, stool frequency, VAS score.

Main Results:

• Significant improvement in PAC-QoL scores was observed post-treatment (P=0.047).
• No statistically significant changes were noted in PAC-SYM scores (P=0.53).
• Improvements in weekly stool frequency and VAS scores were not statistically significant (P=0.229 and 0.161, respectively); 26% of patients showed improvement in both PAC-QoL and PAC-SYM, with two reporting complete cure.

Conclusions:

• Bilateral TTNS demonstrates potential efficacy in a subset of chronic constipation patients (approximately 26%).
• Careful patient selection, potentially those with less severe disease, may enhance treatment benefits.
• Further research is warranted to confirm these findings and optimize patient selection for TTNS therapy.