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Sacral nerve stimulation not effective for treating refractory slow transit constipation
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Sacral nerve stimulation did not improve the frequency of complete bowel movements in patients with refractory slow transit constipation, according to new research data.
Researchers from Australia performed an 18-week prospective, randomized, double-blind, placebo-controlled crossover study to assess the efficacy of sacral nerve stimulation (SNS) for severe idiopathic slow transit constipation. They recruited 59 eligible participants (4 male; median age, 42 years; range, 19-74 years) with confirmed slow transit constipation between November 2006 and March 2011 at St. George Hospital and Concord Hospital in Sydney, all of whom completed a 3-week stool diary prior to inclusion.
The primary outcome measure was the number of patients who reported a bowel movement with a feeling of complete evacuation on more than 2 days per week for at least 2 of 3 weeks. First, patients underwent 3 weeks of temporary peripheral nerve evaluation, 28% of whom responded. Then after permanent SNS implantation (n = 55), the first and second phases of the trial compared subsensory and suprasensory SNS, respectively, with sham stimulation each for 3 weeks with 2-week washout periods separating phases and crossover.
The proportion of patients who fulfilled the primary outcome was comparable between suprasensory (30%) and sham (21%), as well as between subsensory (25%) and sham stimulation (25%).
The researchers also concluded “when compared with sham, active stimulation had no significant impact on any of the tertiary outcome measures ([quality of life], stool frequency, global satisfaction and bothersome scores, days/week laxative use, number of defecating episodes associated with straining, and/or a feeling of complete evacuation.” – by Adam Leitenberger
Disclosures: Dinning reports he received salary support form Medtronic Australasia, and has been paid for expert testimony at meetings organized and run by Medtronic Australasia. Please see the full study for a list of all other authors’ relevant financial disclosures.
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