Magnetic stimulation: A novel method for the treatment of chronic constipation

Abstract

SummaryOur earlier studies have demonstrated that evacuation of the water-filled rectum can be achieved by means of intermittent sacral magnetic stimulation (MS). This paper investigates the effect of sacral MS in rectal inertia presenting with chronic constipation. 28 patients with chronic constipation entered the study: 14 test and 14 controls. The test group comprised 10 women and four men (age 38.6 ± 4.2 years). Investigations revealed constipation to be due to rectal inertia. Intestinal transit was delayed and markers accumulated in the rectum. Defeeography showed no features of anismus or perineal descent. The control group matched the test group in age, gender and investigative findings. The rectal and rectal neck (anal canal) pressures were measured by perfused tubes during intermittent sacral MS, using a magnetic coil applied to the back with its centre located between L4 and L5 along the midline. The magnetic stimulator produced a stimulation set at a 70% intensity, 40 Hz frequency and 2-s burst length, with 2 s off. The effect of sacral MS on the abdominal muscles was tested by inserting an EMG needle electrode into each rectus abdominis muscle. All the above measures were performed alike for the test and control groups, except that the magnetic coil in the latter was not stimulated. Intermittent sacral MS effected significant rectal pressure rise (p<0.001) and rectal neck pressure decline (p<0.01). Defecation occurred in all the test subjects after a mean of 26.3 ± 6.7 intermittent pulse stimulations. Rectus abdominis muscles did not contract during MS. In the control group, defecation did not occur. Sacral MS succeeded in inducing defecation in patients with chronic constipation resulting from rectal inertia. The procedure is simple, easy, non-invasive, non-radiologic and has no complications. Further studies on a large number of patients need to be performed to reproduce the results.