title: Daily transabdominal electrical stimulation at home increased defecation in children with slow-transit constipation: a pilot study.
abstract: OBJECTIVE
  Transcutaneous electrical stimulation (TES) (3 sessions/wk) over the abdomen stimulated bowel functions in a randomized controlled trial. This pilot study assessed whether daily TES at home with a safe, portable machine would be possible and more efficacious than trial results.
  
  
  METHODS
  Eleven patients (6 male/5 female; mean age, 14 years; range, 12-18 years) with slow-transit constipation who relapsed or responded poorly in the trial were recruited (11 +/- 5 months later). An EPM-IF-4160 (Fuji Dynamics, Hong Kong) portable machine (sine waveform, 4 kHz carrier frequency, 80-160 Hz beat frequency, intensity <33 mA) delivering interferential current (2 electrodes over epigastrium + 2 over kidneys) was applied 1 hour daily at home. Continence diaries were kept for 1 month before and 2 months during treatment.
  
  
  RESULTS
  All children completed more than 1 month of treatment after baseline recording. Defecation increased in 9 of 11 children, and soiling decreased in 4 of 11 children. There was a significant increase in total episodes of defecation per week (mean +/- SD, 2.5 +/- 2.1 vs 6.7 +/- 4.4; P = .008) and a nonsignificant decrease in soiling (3.8 +/- 1.6 vs 1.1 +/- 0.5 episodes/wk, P = .1). Daily stimulation does not affect abdominal pain. No adverse events occurred.
  
  
  CONCLUSIONS
  Daily TES at home is safe and significantly improved bowel function in children who did not respond to 3 times per week of TES. Home TES may be a novel treatment of intractable slow transit constipation, avoiding hospital visits.
authors.affiliation: School of Medicine, University of Melbourne, Melbourne 3050, Australia.
authors.forename: Khairul A
authors.initials: KA
authors.lastname: Ismail
authors.forename: Janet
authors.initials: J
authors.lastname: Chase
authors.forename: Susie
authors.initials: S
authors.lastname: Gibb
authors.forename: Melanie
authors.initials: M
authors.lastname: Clarke
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Catto-Smith
authors.forename: Val J
authors.initials: VJ
authors.lastname: Robertson
authors.forename: John M
authors.initials: JM
authors.lastname: Hutson
authors.forename: Bridget R
authors.initials: BR
authors.lastname: Southwell
mesh_terms: D015746:Abdominal Pain / Q000628:therapy; D000293:Adolescent; D002648:Child; D003248:Constipation / Q000628:therapy*; D003672:Defecation / Q000502:physiology; D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000517:prevention & control / Q000628:therapy; D005260:Female; D005772:Gastrointestinal Transit / Q000502:physiology; D006723:Hong Kong; D006801:Humans; D008297:Male; D008499:Medical Records; D010865:Pilot Projects; D012648:Self Care / Q000379:methods*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods; D016896:Treatment Outcome