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Transcutaneous posterior tibial nerve stimulation in children and adolescents with functional constipation: A
Rebeca Mayara Padilha Rego1, Nilton Carlos Machado2, Mary de Assis Carvalho2
1UNESP - São Paulo State University, Botucatu Medical School, Botucatu.
Insights
Transcutaneous posterior tibial nerve stimulation (PTNS) shows promise for treating functional constipation in children. This noninvasive method may improve bowel movements, stool consistency, and quality of life in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Neuromodulation
- Functional Bowel Disorders
Background:
- Functional constipation affects many children, with some showing limited response to standard treatments.
- Transcutaneous posterior tibial nerve stimulation (PTNS) modulates sacral nerve function, impacting urinary and defecatory control.
- PTNS is a safe, noninvasive neuromodulation technique with potential for pediatric applications.
Purpose of the Study:
- To assess the applicability and clinical outcomes of transcutaneous PTNS in children with functional intestinal constipation.
- To evaluate the efficacy of PTNS in improving bowel habits and quality of life in pediatric patients.
Main Methods:
- A single-center, prospective, longitudinal, interventional study design.
- Children received daily transcutaneous PTNS sessions for 4 weeks.
- Semistructured interviews assessed bowel habits and quality of life pre-intervention, post-intervention, and 4 weeks after intervention.
Main Results:
- The study aimed to demonstrate PTNS efficacy in increasing bowel movement frequency and improving stool consistency.
- The protocol intended to show a reduction in retentive fecal incontinence episodes.
- Improvements in overall quality of life were anticipated as an indirect outcome.
Conclusions:
- Transcutaneous PTNS is a promising, noninvasive therapeutic option for pediatric functional constipation.
- Further research is warranted to establish PTNS as a standard treatment for refractory pediatric constipation.
- This study protocol provides a framework for evaluating PTNS in children, focusing on clinical outcomes and applicability.
Introduction:
A vast majority of children with functional constipation respond to the standard medical treatment. However, a subset of patients may present with an unsatisfactory response and only minor improvement of symptoms. Transcutaneous posterior tibial nerve stimulation (PTNS) involves electrical stimulation of the posterior tibial nerve at the level of the ankle, transcutaneously through electrodes fixated on the overlying skin. Stimulation of the tibial nerve can modulate urinary and defecatory function through the stimulation of sacral nerves. Thus, transcutaneous PTNS can be considered a very promising, noninvasive, and safe method to be used in the pediatric age group. However, there is still no published study that has investigated its use in children for the treatment of intestinal constipation. This is a single-center, prospective, longitudinal, and interventional study designed to assess the applicability and clinical outcomes of transcutaneous PTNS in children with functional intestinal constipation. Children will be submitted to daily sessions of transcutaneous PTNS for a period of 4 weeks. All children will also be invited to participate in semistructured interviews, 1 in each of the 3 assessments: 1 week before the start of the intervention; immediately after the 4 weeks of intervention; and 4 weeks after the end of the intervention period. In these interviews, the aspects related to bowel habits and quality of life will be assessed. This project aims to evaluate the clinical outcomes of transcutaneous PTNS in children with functional intestinal constipation and the applicability of this kind of treatment.
Conclusions:
This protocol intended to demonstrate the efficacy of this promising method to increase the number of bowel movements and the stool consistency, to reduce the number of episodes of retentive fecal incontinence, and to indirectly improve the overall quality of life.
