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Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation

Most children with functional constipation (FC) improve with conventional treatments. However, a proportion of children have poor treatment outcomes. Management of intractable FC may include botulinum toxin injections, transanal irrigation, antegrade enemas, colonic resections, and in some cases sac...

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Autores principales: Velasco-Benitez, Carlos, Villamarin, Eder, Mendez, Melissa, Linero, Alfredo, Hungria, Gregory, Saps, Miguel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838342/
https://www.ncbi.nlm.nih.gov/pubmed/36637541
http://dx.doi.org/10.1007/s00431-022-04798-w
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author Velasco-Benitez, Carlos
Villamarin, Eder
Mendez, Melissa
Linero, Alfredo
Hungria, Gregory
Saps, Miguel
author_facet Velasco-Benitez, Carlos
Villamarin, Eder
Mendez, Melissa
Linero, Alfredo
Hungria, Gregory
Saps, Miguel
author_sort Velasco-Benitez, Carlos
collection PubMed
description Most children with functional constipation (FC) improve with conventional treatments. However, a proportion of children have poor treatment outcomes. Management of intractable FC may include botulinum toxin injections, transanal irrigation, antegrade enemas, colonic resections, and in some cases sacral nerve stimulation (SNS). SNS is surgically placed, not readily available and expensive. Posterior tibial nerve stimulation (PTNS) allows transmission of electronic impulses and retrograde stimulation to the sacral nerve plexus in a portable, simple and non-invasive fashion. To assess the efficacy and safety of transcutaneous PTNS for the treatment of FC in children. Single-center, prospective interventional study. Children 4–14 years with Rome IV diagnosis of FC received ten daily PTNS (30 min/day) sessions. Electrodes placed over skin of ankle. Strength of stimulus was below pain threshold. Outcomes were assessed during treatment and 7 days after. Twenty-three subjects enrolled. Two children excluded (acute gastroenteritis, COVID-19 contact). Twenty completed the study (4–14 years), (8.4 ± 3.2 years, 71.4% female). We found significant improvement in the consistency of bowel movements (BM) (p = 0.005), fecal incontinence (FI) (p = 0.005), abdominal pain presence (p = < 0.001) and intensity (p = 0.005), and a significant for improvement in blood in stools (p = 0.037). There was 86.3% improvement in abdominal pain. 96.7% reported treatment satisfaction. Only one child required rescue therapy. Conclusion: We found significant improvement in stool consistency, FI, abdominal pain, and hematochezia. This suggests that transcutaneous PTNS could be a promising noninvasive treatment for FC in children. Large studies are needed.
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spelling pubmed-98383422023-01-17 Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation Velasco-Benitez, Carlos Villamarin, Eder Mendez, Melissa Linero, Alfredo Hungria, Gregory Saps, Miguel Eur J Pediatr Research Most children with functional constipation (FC) improve with conventional treatments. However, a proportion of children have poor treatment outcomes. Management of intractable FC may include botulinum toxin injections, transanal irrigation, antegrade enemas, colonic resections, and in some cases sacral nerve stimulation (SNS). SNS is surgically placed, not readily available and expensive. Posterior tibial nerve stimulation (PTNS) allows transmission of electronic impulses and retrograde stimulation to the sacral nerve plexus in a portable, simple and non-invasive fashion. To assess the efficacy and safety of transcutaneous PTNS for the treatment of FC in children. Single-center, prospective interventional study. Children 4–14 years with Rome IV diagnosis of FC received ten daily PTNS (30 min/day) sessions. Electrodes placed over skin of ankle. Strength of stimulus was below pain threshold. Outcomes were assessed during treatment and 7 days after. Twenty-three subjects enrolled. Two children excluded (acute gastroenteritis, COVID-19 contact). Twenty completed the study (4–14 years), (8.4 ± 3.2 years, 71.4% female). We found significant improvement in the consistency of bowel movements (BM) (p = 0.005), fecal incontinence (FI) (p = 0.005), abdominal pain presence (p = < 0.001) and intensity (p = 0.005), and a significant for improvement in blood in stools (p = 0.037). There was 86.3% improvement in abdominal pain. 96.7% reported treatment satisfaction. Only one child required rescue therapy. Conclusion: We found significant improvement in stool consistency, FI, abdominal pain, and hematochezia. This suggests that transcutaneous PTNS could be a promising noninvasive treatment for FC in children. Large studies are needed. Springer Berlin Heidelberg 2023-01-13 2023 /pmc/articles/PMC9838342/ /pubmed/36637541 http://dx.doi.org/10.1007/s00431-022-04798-w Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Research
Velasco-Benitez, Carlos
Villamarin, Eder
Mendez, Melissa
Linero, Alfredo
Hungria, Gregory
Saps, Miguel
Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
title Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
title_full Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
title_fullStr Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
title_full_unstemmed Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
title_short Efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
title_sort efficacy of transcutaneous posterior tibial nerve stimulation in functional constipation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838342/
https://www.ncbi.nlm.nih.gov/pubmed/36637541
http://dx.doi.org/10.1007/s00431-022-04798-w
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