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Electrical stimulation, pelvic floor exercises improve constipation in children
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Children who received a combination of interferential electrical stimulation and pelvic floor muscle exercises as treatment for functional constipation saw significant improvement of their symptoms, according to the results of a randomized controlled trial published in The American Journal of Gastroenterology.
Lida Sharifi-Rad, PT, MS, of the Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Iran, and colleagues found that the treatment both increased defecation frequency and improved other symptoms of constipation.
“Pediatric functional constipation with no response to conventional corrective medical and dietary treatments poses a burden on the affected patients and may prompt a need for invasive surgical intervention,” the researchers wrote.
They conducted a single-center, double-blind randomized clinical trial in Tehran from January 2014 to April 2017 that included 90 patients aged between 5 years and 13 years, all with a confirmed diagnosis of functional constipation. All the patients had received routine medical treatments for constipation, such as dietary modifications and laxatives, but failed to see any results.
Researchers randomly assigned the patients 1:1 into case and control groups.
The case group underwent pelvic floor muscle (PFM) exercises plus interferential (IF) electrical stimulation, while the control group received sham IF electrical stimulation to go along with the same PFM exercises.
The primary outcome was the absence of functional constipation, and the secondary outcomes were to measure an increase in defecation frequency, absence of fecal soiling and absence of abnormal stool, as well as other factors.
Researchers saw improvement in both study groups at the end of the treatment sessions. However, they found that the number of patients successfully fulfilling the diagnostic criteria in the case group (38/45 patients, 84.4%) compared with the control group (19/44, 43.2%) was a statistically significant reduction (P < 0.003).
The number of patients fulfilling the criteria after a 6-month follow-up period remained significantly lower in the case group (32/45, 71.1%) than in the control group (16/44, 36.4%; P < 0.001).
Patients in the case group also saw improvements in their defecation frequency, painful defecation, stool form, fecal soiling episodes, and in their constipation and pain scores compared with their counterparts in the control group.
“This treatment program increased defecation frequency, and decreased fecal incontinence frequency and painful defecation as well,” the researchers wrote. “More importantly, this method is a safe and non-invasive intervention that prompts further investigation with larger samples and longer follow-up periods.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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