title: A randomised, controlled study of small intestinal motility in patients treated with sacral nerve stimulation for irritable bowel syndrome.
abstract: BACKGROUND
  Irritable bowel syndrome (IBS) is among the most common gastrointestinal disorders worldwide. In selected patients with severe diarrhoea-predominant or mixed IBS subtypes sacral nerve stimulation (SNS) alleviates IBS-specific symptoms and improves quality of life. The mode of action, however, remains unknown. The present study aimed to evaluate the effect of SNS on small intestinal motility in IBS patients.
  
  
  METHODS
  Twenty patients treated with SNS for severe diarrhoea-predominant or mixed IBS were included in a randomised, controlled, crossover study. The neurostimulator was turned ON or OFF for the first one month and then to the opposite setting for the next month. Gastrointestinal transit patterns were investigated with the Motility Tracking System-1 (MTS-1) at the end of each the ON and OFF period. Primary endpoint was change in the velocity of the magnetic pill within the small intestine. Statistical testing was performed with Wilcoxon's rank sum test and Fisher's exact test.
  
  
  RESULTS
  The median velocity of the magnetic pill through the small intestine in the fasting state was not significantly different between periods with and without SNS (Group ON-OFF: median change 0 m/h (range -1.07, 0.63), Group OFF-ON: median change 0.27 m/h (range -0.59, 1.12)) (p = 0.25). Neither, was the median velocity of the magnetic pill through the small intestine in the postprandial state significantly different between periods with and without SNS (Group ON-OFF: median change -0.13 m/h (range -0.46, 0.23), Group OFF-ON: median change 0.015 m/h (range -0.48, 0.59)) (p = 0.14).
  
  
  CONCLUSIONS
  Even though SNS may reduce symptoms of diarrhoea-predominant and mixed IBS, it has no detectable effect on small intestinal transit patterns.
  
  
  BACKGROUND
  Clinical.trials.gov, (NCT00919672).
authors: Department of Surgery, P, Aarhus University Hospital, Aarhus, Denmark. janfas@rm.dk.
authors: Janne
authors: J
authors: Fassov
authors: Lilli
authors: L
authors: Lundby
authors: Jonas
authors: J
authors: Worsøe
authors: Steen
authors: S
authors: Buntzen
authors: Søren
authors: S
authors: Laurberg
authors: Klaus
authors: K
authors: Krogh
mesh_terms: D000328:Adult; D003248:Constipation / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D018592:Cross-Over Studies; D003967:Diarrhea / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D005772:Gastrointestinal Transit / Q000502:physiology*; D006801:Humans; D007421:Intestine, Small / Q000503:physiopathology*; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008160:Lumbosacral Plexus; D059346:Magnets; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult