Transcutaneous electrical nerve stimulation therapy for intractable childhood constipation: a clinical observational...

To determine the efficacy of transcutaneous electrical nerve stimulation (TENS) on children with intractable constipation and compare treatment success between TENS application twice weekly and three times weekly.

We recruited otherwise healthy consecutive children aged 6-17 years old suffering from intractable constipation over a 6-month period. Anatomic causes and organic pathologies were ruled out. All children received TENS treatment for 20 min, during 4 weeks, three times a week in group 1 and twice a week in group 2 for 4 weeks. Patients were evaluated for defecation frequency, stool consistency, symptom relief, and fecal incontinence before, at the first week, at the end, and 4 weeks after treatment was discontinued.

Twenty patients were enrolled in group 1 and 15 in group 2. Age, gender, and duration of constipation were indifferent among groups. After treatment, there was a significant increase in the number of weekly defecations ( P  < 0.001), improvement in fecal incontinence ( P  < 0.05), and painful defecation ( P  < 0.001) in both groups; however, each group's improvements did not persist 4 weeks after the treatment's discontinuation ( P  > 0.05). Meanwhile, twice weekly TENS was as effective as three-times weekly TENS ( P  > 0.05).

TENS treatment appears to improve weekly defecation, fecal incontinence, and pain in children with intractable constipation; however, effects are not sustained after discontinuation. The twice-weekly and three-times weekly protocols yielded comparable results; however, the study lacked sufficient power to conclusively demonstrate noninferiority.