Electrical stimulation effective in adults with constipation

Home-based transabdominal interferential electrical stimulation may be effective in adults with functional constipation, a small Australian study suggests.

A randomised controlled trial of 33 women at the Alfred Hospital found the intervention, delivered at home for one hour each day for six weeks, improved symptoms compared to a sham treatment.

Following the study period, more than half (53%) of the intervention group achieved the primary outcome of three or more spontaneous bowel movements per week compared to just 12.6% of the control women (p=0.02).

The intervention also helped more women than controls (66% v 14%) reduce their laxative use by more than half (p=0.01).

Patient Assessment of Constipation-Symptoms (PAC-SYM) and overall symptom scores were also lower in the treated group of women.

The study found the benefits of treatment in terms of both the primary outcome and secondary outcomes were maintained at three months.

“Statistically significant differences were maintained across both primary and the secondary outcomes of PAC-SYM (P = 0.02) and VAS symptom score (P = 0.02), and differences in the PAC-QOL were also evident (P = 0.001).”

There were no adverse events believed to be related to the intervention.

“Thus, the findings support interferential therapy as a safe, noninvasive means of treating symptoms of constipation in adult women,” the study said.

It also said the findings were consistent with the evidence in children.

“In the present study stimulation was performed for 6 weeks at a daily basis at home. This was based on previous paediatric studies which found home stimulation to be easy, well tolerated with a larger effect seen compared with studies that used intermittent stimulation (3 × a week).”

However more work will be needed to determine optimal delivery duration and frequency, to define mechanisms of action, and to determine predictors of response, it said.

At the moment, it is not clear if any benefit is due to direct effects on visceral intrinsic pathways or via more remote effects such as changes in sacral or spinal sympathetic outflow.

The findings are published in Alimentary Pharmacology and Therapeutics.

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