Abstract
Purpose
Slow transit constipation is a common disorder in children, which often does not respond well to ordinary treatments. We have conducted a systematic review of reported studies in order to better define the current state of knowledge about electrical stimulation treatment of slow transit constipation in children.
Methods
We searched PubMed, Embase, Cochrane Library, BioMed Central, and ISI Web of Knowledge with relevant terms; six studies, all from one center, met the criteria for inclusion. Two trials were randomized clinical trials, and four were prospective studies. The number of subjects included in the studies was 8 to 39, with ages 3 to 18 years.
Results
Treatment sessions varied from 20 to 30 min 3 times per week to 1 h daily, and duration of therapy varied from 3 weeks to 6 months. Statistically significant improvements after electrical stimulation therapy were recorded in one to four outcome measures in each of the studies: frequency of defecation, soiling, Bristol Stool Scale, radionuclear transit studies, and quality of life; however, the improvements were of modest degree and of uncertain clinical significance. Quality assessment of the studies found various levels of bias, with attrition bias and reporting bias in all six.
Conclusions
This systemic review found moderate support for the effectiveness of electrical stimulation therapy in slow transit constipation in children. However, better-designed studies, with larger and more diverse patient populations followed for longer time periods, will be needed in order to reliably determine the efficacy of electrical stimulation therapy in the treatment of this disorder.
Similar content being viewed by others
References
Bassotti G, Blandizzi C (2014) Understanding and treating refractory constipation. World J Gastrointest Pharmacol Ther 6:77–85
Bove A, Bellini M, Battaglia E, Bocchini R, Gambaccini D, Bove V, Pucciani F, Altomare DF, Dodi G, Sciaudone G, Falletto E, Piloni V (2012) Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment). World J Gastroenterol 28:4994–5013
Hutson JM, Chase JW, Clarke MC, King SK, Sutcliffe J, Gibb S, Catto-Smith AG, Robertson VJ, Southwell BR (2009) Slow-transit constipation in children: our experience. Pediatr Surg Int 25:403–406
Southwell BR, King SK, Hutson JM (2005) Chronic constipation in children: organic disorders are a major cause. J Paediatr Child Health 41:1–15
Chase J, Robertson VJ, Southwell B, Hutson J, Gibb S (2005) Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment-resistant constipation and soiling in children. J Gastroenterol Hepatol 20:1054–1061
Clarke MC, Catto-Smith AG, King SK, Dinning PG, Cook IJ, Chase JW, Gibb SM, Robertson VJ, Simpson D, Hutson JM, Southwell BR (2012) Transabdominal electrical stimulation increases colonic propagating pressure waves in paediatric slow transit constipation. J Pediatr Surg 47:2279–2284
Yik YI, Ismail KA, Hutson JM, Southwell BR (2012) Home transcutaneous electrical stimulation to treat children with slow-transit constipation. J Pediatr Surg 47:1285–1290
Leong LC, Yik YI, Catto-Smith AG, Robertson VJ, Hutson JM, Southwell BR (2011) Long-term effects of transabdominal electrical stimulation in treating children with slow-transit constipation. J Pediatr Surg 46:2309–2312
Clarke MC, Chase JW, Gibb S, Robertson VJ, Catto-Smith A, Hutson JM, Southwell BR (2009) Decreased colonic transit time after transcutaneous interferential electrical stimulation in children with slow transit constipation. J Pediatr Surg 44:408–412
Clarke MC, Chase JW, Gibb S, Hutson JM, Southwell BR (2009) Improvement of quality of life in children with slow transit constipation after treatment with transcutaneous electrical stimulation. J Pediatr Surg 44:1268–1272
Ismail KA, Chase J, Gibb S, Clarke M, Catto-Smith AG, Robertson VJ, Hutson JM, Southwell BR (2009) Daily transabdominal electrical stimulation at home increased defecation in children with slow-transit constipation: a pilot study. J Pediatr Surg 44:2388–2392
Gutierrez C, Marco A, Nogales A, Tebar R (2002) Total and segmental colonic transit time and anorectal manometry in children with chronic idiopathic constipation. J Pediatr Gastroenterol Nutr 35:31–38
Shin YM, Southwell BR, Stanton MP, Hutson JM (2002) Signs and symptoms of slow-transit constipation versus functional retention. J Pediatr Surg 37:1762–1765
Clarke MC, Chow CS, Chase JW, Gibb S, Hutson JM, Southwell BR (2008) Quality of life in children with slow transit constipation. J Pediatr Surg 43:320–324
Yik YI, Clarke MC, Catto-Smith AG, Robertson VJ, Sutcliffe JR, Chase JW, Gibb S, Cain TM, Cook DJ, Tudball CF, Hutson JM, Southwell BR (2011) Slow-transit constipation with concurrent upper gastrointestinal dysmotility and its response to transcutaneous electrical stimulation. Pediatr Surg Int 27:705–711
Higgins J, Green S (2011) Cochrane handbook for systematic reviews of interventions Version 5.1. 0 [updated March 2011]. The Cochrane Collaboration, Chichester
Acknowledgments
None
Conflicts of interest
There is no existing conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lu, ML., He, J. & Lu, S. Electrical stimulation therapy for slow transit constipation in children: a systematic review. Int J Colorectal Dis 30, 697–702 (2015). https://doi.org/10.1007/s00384-015-2180-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00384-015-2180-3