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KMID : 0812020130190030366
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Korean Journal of Neurogastroenterology and Motility
2013 Volume.19 No. 3 p.366 ~ p.373
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Electrical Stimulation Therapy in Chronic Functional Constipation: Five Years’ Experience in Patients Refractory to Biofeedback Therapy and With Rectal Hyposensitivity
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Jung Kee-Wook
Yang Dong-Hoon
Yoon In-Ja
Seo So-Young
Koo Hyun-Sook
Lee Hyo-Jeong
Lee Ho-Su
Kim Ji-Beom
Kim Jong-Wook
Park Soo-Kyung
Park Sang-Hyoung
Kim Kyung-Jo
Ye Byong-Duk
Byeon Jeong-Sik
Jung Hwoon-Yong
Yang Suk-Kyun
Kim Jin-Ho
Myung Seung-Jae
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Abstract
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Background/Aims Biofeedback therapy (BFT) can be unsuccessful in constipated patients, even those with pelvic floor dysfunction. Electrical stimulation therapy (EST) has been introduced as a novel therapeutic modality in patients with chronic constipation, especially those who have rectal hyposensitivity. We evaluated the efficacy of EST based on five years’ clinical experience. Methods From January 2002 to February 2007, 159 patients underwent EST. After exclusion of 12 drop-outs, 147 (M:F = 61:86, 49 ± 17 years) finished all treatment sessions. Among them, 88 (M:F = 29:59, 49 ± 17 years) were refractory to BFT without rectal hyposensitivity (RH), and 59 (M:F = 32:27, 54 ± 17 years) were those with RH. Results The overall response to EST was 59.2% (87/147) by per-protocol analysis. In the EST-responsive group, overall satisfaction improved significantly (from 7.3 ± 3.0 to 4.3 ± 2.5, P ＜ 0.05). Subgroup analysis showed that the response rate was 64.8% (57/88) in patients refractory to BFT without RH, and 50.8 % (30/59) in those with RH. Conclusions EST may have additional therapeutic efficacy in patients who are refractory to BFT. EST may also be effective in patients with RH, including restoration of rectal sensation. Therefore, EST could be considered as an alternative choice in patients refractory to BFT and with or without RH.
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KEYWORD
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Biofeedback, Constipation, Electric stimulation therapy
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