title: Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment-resistant constipation and soiling in children.
abstract: BACKGROUND
  Chronic constipation in children may have organic or behavioral causes. The purpose of the present study was to investigate the effect of treatment with transcutaneous electrical stimulation (using interferential current) in children with chronic treatment-resistant constipation with proven organic disorders.
  
  
  METHODS
  Eight children (7-16 years) with at least 4 years of chronic treatment-resistant constipation and soiling, who had failed diet, laxative treatment and behavioral therapy were given 1 month of transcutaneous electrical stimulation. The three most severe cases had appendicostomies with antegrade washouts every 2-3 days to prevent impaction and reduce their soiling. Children and carers kept a daily diary of bowel habits, recording number of spontaneous defecations, episodes of soiling, use of bowel washouts and medications. Transcutaneous stimulation using interferential current was applied three times per week for 3-4 weeks using four surface electrodes, two to the paraspinal area of T9-10 to L2 and one to either side of the anterior abdominal wall beneath the costal margin. Diaries were recorded for 1 month before, during, and after stimulation and for 2 weeks 3 months later.
  
  
  RESULTS
  Transcutaneous electrical stimulation using interferential current stopped soiling in 7/8 children and increased the frequency of spontaneous defecations in 5/8. Defecations remained high and soiling low for 3 months in 3/6 children (with data).
  
  
  CONCLUSIONS
  These results suggest that transcutaneous electrical stimulation using interferential current has a beneficial effect for children with chronic treatment-resistant constipation. Further trials using larger series of patients are needed to confirm this benefit, to determine the ideal stimulation parameters and to investigate why electrical stimulation might be effective.
authors.affiliation: School of Physiotherapy, The University of Melbourne, Victoria, Australia. chase@unimelb.edu.au
authors.forename: Janet
authors.initials: J
authors.lastname: Chase
authors.forename: Val J
authors.initials: VJ
authors.lastname: Robertson
authors.forename: Bridget
authors.initials: B
authors.lastname: Southwell
authors.forename: John
authors.initials: J
authors.lastname: Hutson
authors.forename: Susie
authors.initials: S
authors.lastname: Gibb
mesh_terms: D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D003672:Defecation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010865:Pilot Projects; D012189:Retrospective Studies; D012720:Severity of Illness Index; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome