title: Electrical stimulation therapy in chronic functional constipation: five years' experience in patients refractory to biofeedback therapy and with rectal hyposensitivity.
abstract: OBJECTIVE
  Biofeedback therapy (BFT) can be unsuccessful in constipated patients, even those with pelvic floor dysfunction. Electrical stimulation therapy (EST) has been introduced as a novel therapeutic modality in patients with chronic constipation, especially those who have rectal hyposensitivity. We evaluated the efficacy of EST based on five years' clinical experience.
  
  
  METHODS
  From January 2002 to February 2007, 159 patients underwent EST. After exclusion of 12 drop-outs, 147 (M:F = 61:86, 49 ± 17 years) finished all treatment sessions. Among them, 88 (M:F = 29:59, 49 ± 17 years) were refractory to BFT without rectal hyposensitivity (RH), and 59 (M:F = 32:27, 54 ± 17 years) were those with RH.
  
  
  RESULTS
  The overall response to EST was 59.2% (87/147) by per-protocol analysis. In the EST-responsive group, overall satisfaction improved significantly (from 7.3 ± 3.0 to 4.3 ± 2.5, P < 0.05). Subgroup analysis showed that the response rate was 64.8% (57/88) in patients refractory to BFT without RH, and 50.8% (30/59) in those with RH.
  
  
  CONCLUSIONS
  EST may have additional therapeutic efficacy in patients who are refractory to BFT. EST may also be effective in patients with RH, including restoration of rectal sensation. Therefore, EST could be considered as an alternative choice in patients refractory to BFT and with or without RH.
authors.affiliation: Asan Digestive Disease Research Institute, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kee Wook
authors.initials: KW
authors.lastname: Jung
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Yang
authors.forename: In Ja
authors.initials: IJ
authors.lastname: Yoon
authors.forename: So Young
authors.initials: SY
authors.lastname: Seo
authors.forename: Hyun Sook
authors.initials: HS
authors.lastname: Koo
authors.forename: Hyo Jeong
authors.initials: HJ
authors.lastname: Lee
authors.forename: Ho Su
authors.initials: HS
authors.lastname: Lee
authors.forename: Ji-Beom
authors.initials: JB
authors.lastname: Kim
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Soo Kyung
authors.initials: SK
authors.lastname: Park
authors.forename: Sang Hyoung
authors.initials: SH
authors.lastname: Park
authors.forename: Kyung Jo
authors.initials: KJ
authors.lastname: Kim
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Byeon
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Suk-Kyun
authors.initials: SK
authors.lastname: Yang
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
keywords: Biofeedback; Constipation; Electric stimulation therapy