title: A comparative study of transcutaneous interferential electrical stimulation plus behavioral therapy and behavioral therapy alone on constipation in postoperative Hirschsprung disease children.
abstract: OBJECTIVE
  We assessed the effectiveness of transcutaneous interferential (IF) electrical stimulation on constipation in postoperative Hirschsprung's disease (HD) patients.
  
  
  METHODS
  Thirty HD children (18 boys and 12 girls) with constipation who had no surgical complication were enrolled and then randomly divided into two treatment groups. The control group underwent only behavioral therapy comprising high fiber diet, hydration, toilet training and pelvic floor muscles exercises while; the IF group underwent behavioral therapy plus IF electrical stimulation. Patients underwent anorectal manometry before and 6months after the treatment. In addition, a complete bowel diary with data on the frequency of defecation per week, stool form and the number of fecal soiling episodes, a constipation score and a visual pain score were obtained from all patients before, after treatment and 6months later.
  
  
  RESULTS
  Constipation symptoms were improved in 10 (66%) and 4 (26.6%) patients in IF and control groups, respectively at 6months of follow up (P<0.03). Frequency of defecation per week significantly increased after the treatment in the IF group compared with control group at the 6months of follow up (5.4±2.1 vs. 3.3±1.8 per week, respectively; P<0.009). In addition, mean pain score was significantly decreased in IF group compared with controls after treatment (P<0.05).
  
  
  CONCLUSIONS
  IF electrical stimulation is an effective adjunct to behavioral therapy to overcome symptoms of constipation in postoperative HD patients.
authors.affiliation: Department of Pediatric Surgery, Pediatric Center Excellence, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran (IRI); Universal Scientific Education and Research Network (USERN), Tehran, Iran (IRI). Electronic address: Ladiseyedian.sanam@gmail.com.
authors.forename: Seyedeh-Sanam
authors.initials: SS
authors.lastname: Ladi-Seyedian
authors.affiliation: Department of Pediatric Surgery, Pediatric Center Excellence, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran (IRI); Rehabilitation Clinic, Pediatric Center Excellence, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran (IRI); Universal Scientific Education and Research Network (USERN), Tehran, Iran (IRI). Electronic address: l-sharifirad@farabi.tums.ac.ir.
authors.forename: Lida
authors.initials: L
authors.lastname: Sharifi-Rad
authors.affiliation: Department of Pediatric Surgery, Pediatric Center Excellence, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran (IRI). Electronic address: dr.navid.manouchehri@gmail.com.
authors.forename: Navid
authors.initials: N
authors.lastname: Manouchehri
authors.affiliation: Department of Pediatric Surgery, Pediatric Center Excellence, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran (IRI). Electronic address: Ashjaei@sina.tums.ac.ir.
authors.forename: Bahar
authors.initials: B
authors.lastname: Ashjaei
mesh_terms: D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003248:Constipation / Q000209:etiology / Q000628:therapy*; D003672:Defecation / Q000502:physiology; D005260:Female; D005767:Gastrointestinal Diseases; D006627:Hirschsprung Disease / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome
keywords: Children; Constipation; Electrical stimulation; Fecal soiling; Hirschsprung's disease