Related Experiment Video
Updated: Aug 14, 2025
Author Spotlight: Unveiling the Therapeutic Effects of FSN Treatment – Bridging Research and Clinical Applications in Neuropathic Pain
Published on: June 30, 2023
Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
Carlos Velasco-Benitez1, Eder Villamarin1, Melissa Mendez1
1Universidad del Valle, Calle 13 # 100-00, Cali Valle Del Cauca, Cali, Colombia.
Insights
Posterior tibial nerve stimulation (PTNS) offers a promising, non-invasive treatment for children with functional constipation. This therapy significantly improved bowel movements, reduced pain, and increased treatment satisfaction in a recent study.
Area of Science:
- Pediatric Gastroenterology
- Neurology
- Physical Medicine and Rehabilitation
Background:
- Functional constipation is a common pediatric disorder managed with conventional approaches.
- Intractable cases may require invasive treatments like sacral nerve stimulation (SNS).
- Posterior tibial nerve stimulation (PTNS) presents a non-invasive alternative for stimulating the sacral nerve plexus.
Purpose of the Study:
- To evaluate the efficacy and safety of transcutaneous PTNS for treating functional constipation in children.
- To assess improvements in bowel function, pain, and incontinence.
- To determine patient satisfaction with the PTNS therapy.
Main Methods:
- A single-center, prospective interventional study was conducted on children aged 4-14 with Rome IV functional constipation.
- Participants received ten daily 30-minute sessions of transcutaneous PTNS with electrodes on the ankle.
- Stimulus intensity was kept below the pain threshold, with outcomes assessed during and after treatment.
Main Results:
- Twenty children completed the study, showing significant improvements in stool consistency (p=0.005) and fecal incontinence (p=0.005).
- Abdominal pain presence (p<0.001) and intensity (p=0.005) significantly decreased, with an 86.3% improvement.
- Blood in stools (p=0.037) also showed significant improvement, and 96.7% reported treatment satisfaction.
Conclusions:
- Transcutaneous PTNS demonstrated significant efficacy in improving stool consistency, fecal incontinence, abdominal pain, and hematochezia in children with functional constipation.
- The therapy is suggested as a promising non-invasive treatment option for pediatric functional constipation.
- Larger studies are recommended to further validate these findings.
Abstract:
Most children with functional constipation (FC) improve with conventional treatments. However, a proportion of children have poor treatment outcomes. Management of intractable FC may include botulinum toxin injections, transanal irrigation, antegrade enemas, colonic resections, and in some cases sacral nerve stimulation (SNS). SNS is surgically placed, not readily available and expensive. Posterior tibial nerve stimulation (PTNS) allows transmission of electronic impulses and retrograde stimulation to the sacral nerve plexus in a portable, simple and non-invasive fashion. To assess the efficacy and safety of transcutaneous PTNS for the treatment of FC in children. Single-center, prospective interventional study. Children 4-14 years with Rome IV diagnosis of FC received ten daily PTNS (30 min/day) sessions. Electrodes placed over skin of ankle. Strength of stimulus was below pain threshold. Outcomes were assessed during treatment and 7 days after. Twenty-three subjects enrolled. Two children excluded (acute gastroenteritis, COVID-19 contact). Twenty completed the study (4-14 years), (8.4 ± 3.2 years, 71.4% female). We found significant improvement in the consistency of bowel movements (BM) (p = 0.005), fecal incontinence (FI) (p = 0.005), abdominal pain presence (p = < 0.001) and intensity (p = 0.005), and a significant for improvement in blood in stools (p = 0.037). There was 86.3% improvement in abdominal pain. 96.7% reported treatment satisfaction. Only one child required rescue therapy.
Conclusion:
We found significant improvement in stool consistency, FI, abdominal pain, and hematochezia. This suggests that transcutaneous PTNS could be a promising noninvasive treatment for FC in children. Large studies are needed.
What Is Known:
• Functional constipation is one of the most common disorders in children. • Current management of functional constipation consists of an integrative approach that includes medications, diet and behavioral strategies.
What Is New:
• Posterior tibial nerve stimulation is a novel noninvasive and easy to use therapy that can improve stool consistency, fecal incontinence and blood in stools.
