AAP Paper
Improvement of quality of life in children with slow transit constipation after treatment with transcutaneous electrical stimulation

https://doi.org/10.1016/j.jpedsurg.2009.02.031Get rights and content

Abstract

Background

Slow transit constipation (STC) causes intractable symptoms not responsive to medical treatment. Children have irregular bowel motions, colicky abdominal pain, and frequent soiling. Transcutaneous electrical stimulation using interferential current (interferential therapy [IFT]) is a novel treatment of STC. This study assessed quality of life (QOL) in STC children before and after IFT treatment.

Methods

Eligible STC children were randomized to receive either real or placebo IFT (12 sessions for 4 weeks). Questionnaires (Pediatric Quality of Life Inventory) were administered before and 6 weeks after treatment, with parallel parent and child self-report scales. Higher scores indicate better QOL. Holschneider and Templeton scores were also obtained. The QOL scores were compared using paired t tests.

Results

Thirty-three children (21 male), with a mean age of 11.8 years (range, 7.4-16.5 years), were recruited; 16 received real IFT. Child-perceived QOL was improved after real IFT compared with baseline (81.1 vs 72.9, P = .005) but not after placebo IFT (78.1 vs 74.9, P = .120). The Holschneider score improved after real IFT (10 vs 8, P = .015) but not after placebo IFT (9 vs 8, P = .112). Parentally perceived QOL was similar after real IFT (70.1 vs 70.3, P = .927) and placebo IFT (70.2 vs 69.8, P = .899). There were no differences in Templeton scores.

Conclusion

Interferential therapy is a novel therapy for children with STC that improves their self-perceived QOL.

Section snippets

Subjects and methods

After attainment of informed consent, subjects were randomized to receive either real or placebo therapy. For 4 weeks, subjects received 12 × 20-minute sessions of either real or placebo IFT (real therapy: carrier frequency, 4 kHz; adjustable intensity with a beat frequency sweep covering 80-120 Hz, with 2 abdominal electrodes placed just below the costal margin and 2 paraspinal electrodes placed over the muscle between T9 and L2). Contraindications to treatment include broken skin at the

Results

Thirty-three children (21 male), with a mean age of 11.8 years (range, 7.4-16.5 years), with STC were recruited. Sixteen children received real IFT. There were no statistical differences between the 2 groups concerning sex, age, onset/duration of symptoms, soiling, and abdominal pain (Table 1).

There was no difference in parentally perceived QOL (PedsQL) after either real (mean, 70.3 vs 70.1; P = .927) or placebo (mean, 69.8 vs 70.2; P = .899) IFT (Fig. 1).

There was no difference in child

Discussion

Slow transit constipation represents a form of chronic constipation that is relatively unresponsive to conventional management consisting of laxatives, dietary modification, behavioral modification, and toilet training [1], [2], [21]. Those with STC experience erratic stool frequency accompanied with colicky abdominal pain and uncontrollable soiling that leads to a significantly poorer QOL than their peers [10]. This is so for both parent- and self-reported scores, with STC appearing to impinge

References (35)

  • WaldA.

    Slow transit constipation

    Curr Treat Options Gastroenterol

    (2002)
  • SouthwellB.R. et al.

    Chronic constipation in children: organic disorders are a major cause

    J Paediatr Child Health

    (2005)
  • ArhanP. et al.

    Segmental colonic transit time

    Dis Colon Rectum

    (1981)
  • LundinE. et al.

    Segmental colonic transit studies: comparison of a radiological and a scintigraphic method

    Colorectal Dis

    (2007)
  • NotghiA. et al.

    Simplified method for the measurement of segmental colonic transit time

    Gut

    (1994)
  • ChaseJ. et al.

    Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment-resistant constipation and soiling in children

    J Gastroenterol Hepatol

    (2005)
  • VarniJ.W. et al.

    The PedsQL 4.0 Generic Core Scales: sensitivity, responsiveness, and impact on clinical decision-making

    J Behav Med

    (2002)
  • Cited by (68)

    • Nonpharmacologic Treatment for Children with Functional Constipation: A Systematic Review and Meta-analysis

      2022, Journal of Pediatrics
      Citation Excerpt :

      However, this might only be the case in children with symptoms refractory to conventional treatment, because a large study in primary care setting did not find additional benefit of pelvic physiotherapy.110 Massage therapy,86 abdominal electrical stimulation,78-81 and cryotherapy might directly enhance colonic motility.81 Although evidence is limited and the mode of action remains incompletely understood, these interventions may have a positive effect on functional constipation in children.

    • Non-pharmacologic approach to pediatric constipation

      2021, Complementary Therapies in Medicine
    • Functional Constipation and Fecal Incontinence

      2020, Pediatric Gastrointestinal and Liver Disease, Sixth Edition
    • Gastrointestinal Neuropathies: New Insights and Emerging Therapies

      2018, Gastroenterology Clinics of North America
    View all citing articles on Scopus
    View full text