Electrical stimulation therapy for chronic constipation: a systematic review and meta-analysis

Abstract

IntroductionTreatment of chronic constipation often is challenging, and non-traditional treatment methods, including nonpharmacological methods, may be attempted. Electrical stimulation therapy (EST) has been tried in many small and uncontrolled series. Although most results have been encouraging, validity of the method has not been established.Material and methodsFive articles, concerning 338 patients (average age: 40.8–63.6 years) with constipation, were included in the study. Electroacupuncture or transcutaneous interferential electrical stimulation was the modality used. The causes of the constipation were stroke, slow transit, functional, opioid use, or unknown etiology. The primary and secondary outcomes were response rate and degree of constipation, respectively. Adverse events were also assessed.ResultsThe results of the meta-analysis yielded a significant improvement in treatment response for EST compared with control treatment (medications or sham control), with the odds ratio 4.263 (95% CI: 1.456–12.484, p = 0.008). A significant reduction in degree of constipation also was found, with the pooled estimate of standardized difference in mean change 1.039 (95% CI: 0.315–1.763, p = 0.005). The average percentage of adverse events associated with EST was < 5%.ConclusionsThe EST with electroacupuncture or transcutaneous interferential electrical stimulation for the treatment of constipation due to various causes is effective and reasonably safe. However, further detailed studies using these methods are needed.