Decreased colonic transit time after transcutaneous interferential electrical stimulation in children with slow transit constipation

Clarke, Melanie C.C.; Chase, Janet W.; Gibb, Susie; Robertson, Val J.; Catto-Smith, Anthony; Hutson, John M.; Southwell, Bridget R.

doi:10.1016/j.jpedsurg.2008.10.100

« Previous Next »Journal of Pediatric Surgery
Volume 44, Issue 2 , Pages 408-412, February 2009

Decreased colonic transit time after transcutaneous interferential electrical stimulation in children with slow transit constipation

Melanie C.C. Clarke
- Department of Surgical Research, Royal Children’s Hospital, Melbourne, Victoria 3052, Australia
- Murdoch Childrens Research Institute, Melbourne, Victoria 3052, Australia
Janet W. Chase
- Murdoch Childrens Research Institute, Melbourne, Victoria 3052, Australia
Susie Gibb
- Department of General Paediatrics, Royal Children’s Hospital, Melbourne, Victoria 3052, Australia
Val J. Robertson
- School of Health Sciences, University of Newcastle, Newcastle, NSW 2038, Australia
Anthony Catto-Smith
- Department of Gastroenterology, Royal Children’s Hospital, Melbourne, Victoria 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria 3010, Australia
John M. Hutson
- Department of Surgical Research, Royal Children’s Hospital, Melbourne, Victoria 3052, Australia
- Murdoch Childrens Research Institute, Melbourne, Victoria 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria 3010, Australia
Bridget R. Southwell
- Murdoch Childrens Research Institute, Melbourne, Victoria 3052, Australia
- Corresponding author. Gut Motility Laboratory, Surgical Research Group, Murdoch Childrens Research Institute, Royal Childrens Hospital, Melbourne, Victoria 3052, Australia. Tel.: +61 3 9345 5805; fax: +61 3 9345 7997.

Received 3 October 2008; accepted 23 October 2008.

Abstract

Purpose

Idiopathic slow transit constipation (STC) describes a clinical syndrome characterised by intractable constipation. It is diagnosed by demonstrating delayed colonic transit on nuclear transit studies (NTS). A possible new treatment is interferential therapy (IFT), which is a form of electrical stimulation that involves the transcutaneous application of electrical current. This study aimed to ascertain the effect of IFT on colonic transit time.

Methods

Children with STC diagnosed by NTS were randomised to receive either 12 real or placebo IFT sessions for a 4-week period. After a 2-month break, they all received 12 real IFT sessions—again for a 4-week period. A NTS was repeated 6 to 8 weeks after cessation of each treatment period where able. Geometric centres (GCs) of activity were calculated for all studies at 6, 24, 30, and 48 hours. Pretreatment and posttreatment GCs were compared by statistical parametric analysis (paired t test).

Results

Thirty-one pretreatment, 22 postreal IFT, and 8 postplacebo IFT studies were identified in 26 children (mean age, 12.7 years; 16 male). Colonic transit was significantly faster in children given real treatment when compared to their pretreatment NTS at 24 (mean CG, 2.39 vs 3.04; P ≤ .0001), 30 (mean GC, 2.79 vs 3.47; P = .0039), and 48 (mean GC, 3.34 vs 4.32; P = .0001) hours. By contrast, those children who received placebo IFT had no significant change in colonic transit.

Conclusions

Transcutaneous electrical stimulation with interferential therapy can significantly speed up colonic transit in children with slow transit constipation.

Key words: Slow transit constipation (STC), Children, Interferential therapy (IFT), Scintigraphy