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G-O043 - THE EFFECTIVENESS OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IN THE TREATMENT OF CHILDHOOD CONSTIPATION (ID 1175)
Abstract
Objectives and Study
Transcutaneous electrical nerve stimulation (TENS) is an overlooked non-pharmacological treatment modality for constipation. It is typically studied in difficult cases, with some promising results. Therefore, data on children is still scarce. Our aim is to determine the efficacy of TENS on children with intractable constipation and compare treatment success between TENS application twice-weekly and three times-weekly.
Methods
Otherwise healthy children aged 6 to 17 years old suffering constipation after a high-fiber diet and macrogol therapy over 6 months were recruited. Anatomic causes and organic pathologies were ruled out by appropriate tests. Two electrodes were placed on the abdominal wall and two more on the paraspinal region, and they were linked to Elsa Intelect Nmes TENS equipment (Elsa, Ankara, Turkey). We applied a 250-ms, 10–25 mA and 75-100 Hz current for 20 minutes three times a week to group 1 and twice a week to group 2 for four weeks. Patients were evaluated using the Rome IV criteria before treatment, at first week of treatment, at the end of treatment, and four weeks after treatment was discontinued.
Results
Twenty patients were enrolled in group 1 and 11 in group 2. There was no difference among the groups regarding age, gender, and duration of constipation. After treatment, there was a significant increase in the number of defecations per week (p<0.001), improvement in fecal incontinence (p<0.05), and painful defecation (p<0.001) in both groups. However, these improvements were not sustainable at four weeks after the treatment was discontinued in each group (p>0.05). Meanwhile, twice-weekly TENS was as effective as three times-weekly TENS (p>0.05).
Conclusions
TENS improves the number of weekly stools, fecal incontinence, and pain during defecation in children with intractable constipation. This effect, however, did not last after the treatment was stopped. Moreover, treatment success of TENS application was similar between twice-weekly and three times-weekly.