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Studies assess effectiveness of serotonin and nerve stimulants on irritable bowel syndromes

ill present this study on Wednesday, May 23, at 8:00 a.m. in Hall E.

Sacral Nerve Stimulation for Constipation: An International Multi-Centre Study (Abstract #198)

In patients with idiopathic constipation, which occurs with no identifiable cause, in whom conservative treatment has failed, surgical procedures (e.g., colectomy) are associated with a high failure rate and substantial morbidity. Researchers from five European sites set out to explore an alternative approach: modulating the extrinsic nerve supply to the bowel. In doing so, investigators evaluated the symptomatic response and physiological effect of sacral nerve stimulation in patients with slow transit constipation and normal transit constipation with impaired evacuation.

In this prospective, multi-center trial, 65 patients (58 female) who failed treatment with laxatives and biofeedback (retraining pelvic floor muscle coordination using exercises and electronic aids that create feedback when successful muscle contraction occur) underwent test stimulation, each serving as their own control. The effect of temporary sacral nerve stimulation was assessed by a 21-day bowel habit diary. Patients with more than 50 percent improvement in symptoms were eligible for permanent stimulation. Long-term results were assessed by: bowel habit diary, symptom questionnaire, Cleveland Clinic constipation score (CCCS), visual analogue score (VAS) and short form-36 (SF-36) quality of life questionnaire. Primary endpoints included an increase in the frequency of defecation, reduction in straining and reduction in the sensation of incomplete evacuation.

After a median follow up of 12 months, subjects with both slow transit and impaired evacuation benefited from therapy and 43 patients (66%) proceeded to chronic stimulation. Frequency of defecation increased from 3.4 to 6.1 times per week, while evacuation days per week increased from 2.4 to 4.4. Time spent in facilitie
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Contact: Aimee Frank
AFrank@gastro.org
301-941-2620
American Gastroenterological Association
21-May-2007


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