Three-year follow-up of sacral nerve stimulation for patients with diarrhoea-predominant and mixed irritable bowel syndrome.
OBJECTIVE
Our unit has recently shown that sacral nerve stimulation (SNS) has a significantly positive short-term effect on selected patients with diarrhoea-predominant or mixed irritable bowel syndrome (IBS). The aim of the present prospective study was to evaluate the medium-term efficacy of SNS for IBS to establish whether SNS could have a future role in the treatment of IBS.


METHODS
Patients with IBS who had previously been implanted with a permanent neurostimulator as part of a randomized, controlled, crossover study, were assessed for medium-term follow-up. The primary end-point was change in the IBS-specific symptom score (Gastrointestinal Symptom Rating Scale-Irritable Bowel Syndrome version questionnaire) from baseline to 3-year follow-up. The secondary end-point was a change in the IBS-specific quality of life score (Irritable Bowel Syndrome-Impact Scale questionnaire) from baseline to 3-year follow-up.


RESULTS
Of 26 patients, 20 were eligible for 3-year follow-up. The median IBS-specific symptom score was significantly lower at 3-year follow-up (30, range 13-71) than at baseline (62, 45-80) (P = 0.0001). The effect was observed in all symptom clusters within the score. Also, the median IBS-specific quality of life score was significantly improved at 3-year follow-up (52, 26-169) compared with baseline (135, 82-180, P = 0.0002). The effect was observed in all domains of the score. As per the protocol, 75% of patients were judged therapeutic successes. Seventy per cent of patients had a more than 50% reduction in daily IBS symptoms.


CONCLUSIONS
At medium-term follow-up, SNS continues to be an effective treatment for highly selected patients with diarrhoea-predominant or mixed IBS.
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.|Neurogastroenterology Unit, Department of Hepatology and Gastroenterology V, Aarhus University Hospital, Aarhus, Denmark.
J
J
Fassov
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.
L
L
Lundby
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.
S
S
Laurberg
Surgical Research Unit, Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark.
S
S
Buntzen
Neurogastroenterology Unit, Department of Hepatology and Gastroenterology V, Aarhus University Hospital, Aarhus, Denmark.
K
K
Krogh
D000328:Adult; D003967:Diarrhea / Q000209:etiology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000628:therapy*; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D055815:Young Adult
IBS symptoms; Irritable bowel syndrome; follow-up; quality of life; sacral nerve stimulation