Abstract
Background/Aims: Constipation shows both, a high prevalence and a significant impact. However, it is often perceived as minor and treatment choices are limited. The neuromodulation approach is a valuable option to be considered. This study assesses the use of non-invasive sacral nerve stimulation to reduce constipation in children.Methods: Between February 2013 and May 2015, pediatric patients with chronic constipation were treated with this non-invasive neuromodulation procedure, adapted from classical sacral nerve stimulation. A stimulation device attached to adhesive electrodes on the lower abdomen and back generated an electrical field with a stable frequency of 15 Hz via variable stimulation intensity (1–10 V). The effect of therapy was evaluated in routine check-ups and by specialized questionnaires.Results: The study assessed non-invasive sacral nerve stimulation in 17 patients (9 boys, 8 girls, mean age 6.5 years). They underwent stimulation with 6–9 V for a mean of 11 h per day (range 0.5–24 h) over a mean of 12.7 weeks. Improvement of constipation was achieved in more than half of the patients (12/17) and sustained in almost half of these patients (5/12). Complications were minor (skin irritation, electrode dislocation).Conclusions: Non-invasive sacral nerve stimulation appears to be effective in achieving improvement in pediatric patients with chronic constipation. As an additional external neuromodulation concept, this stimulation may represent a relevant addition to currently available therapeutic options. Further studies are needed to confirm these results.
Highlights
The high prevalence of constipation and an increasing understanding of gastrointestinal function have encouraged interest in new therapeutic approaches [1,2,3]
This study explored the impact of non-invasive sacral nerve stimulation, a transabdominal neuromodulatory approach via electrical stimulation in treatment of pediatric patients by analyzing improvement in symptoms
In 6 patients non-invasive sacral nerve stimulation was applied, but further participation in the study was withdrawn because of unwillingness to adhere to the study protocol, as well as due to lack of acceptance of
Summary
The high prevalence of constipation and an increasing understanding of gastrointestinal function have encouraged interest in new therapeutic approaches [1,2,3]. Prevalence rates in adults are observed at 24.2% by an Italian study using the Rome III criteria, whereas subjective assessment ranks at 34.1% [9]. The Rome III Classification System [10] defines criteria for chronic constipation as three or fewer defecations per week, difficult stool straining, a sensation of anorectal obstruction or incomplete evacuation, and/or manual maneuvers to aid defecation in at least 25% of occasions. With at least two of these symptoms present for at least 3 months, chronic constipation is diagnosed [11]
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