Home transcutaneous electrical stimulation to treat children with slow-transit constipation.
OBJECTIVE
This study aimed to test the effectiveness of home transcutaneous electrical stimulation (TES) when patients with slow-transit constipation (STC) were trained by a naive clinician.


METHODS
A surgeon was trained to teach the TES method to STC children who then self-administered at home (1 hour a day, 3-6 months) using a battery-powered interferential stimulator. Bowel diaries, PedsQL4.0 questionnaires, and radio-nuclear colonic transit studies were completed before and after treatment.


RESULTS
Thirty-two children (16 female; mean age, 8.3 years; range, 3-17 years) self-administered 3 to 6 months of TES. Three did not return diaries. Group 1 (n = 13) started with less than 3 bowel actions per week, and group 2 (n = 16), with more than 3 bowel actions per week. Defecation frequency increased in 69% of group 1 (mean, 1.4-3.0 per week; P = .02). Soiling frequency decreased in 50% of group 2 (5.4-1.9 per week, P = .04). Of 13 patients, 7 improved with development of urge-initiated defecation. Abdominal pain decreased in 48% (1.6 episodes per week to 0.9 per week, P = .06). Stool consistency improved in 56%. There was significant improvement in child-reported and parent-reported PedsQL Scores. Colonic transit improved in 13 of 25 patients.


CONCLUSIONS
Home TES provides a new treatment for STC children, with 50% of treatment-resistant patients benefited. Success requires clinician training and close patient contact. Transcutaneous electrical stimulation increased defecation and reduced soiling.
Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia.
Yee Ian
YI
Yik
Khairul A
KA
Ismail
John M
JM
Hutson
Bridget R
BR
Southwell
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000628:therapy*; D005260:Female; D005772:Gastrointestinal Transit; D006701:Home Nursing; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care; D011795:Surveys and Questionnaires; D004561:Transcutaneous Electric Nerve Stimulation