Slow-transit constipation with concurrent upper gastrointestinal dysmotility and its response to transcutaneous electrical stimulation
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Yee Ian Yik • Melanie C. C. Clarke • Anthony G. Catto-Smith • Val J. Robertson • Jonathan R. Sutcliffe • Janet W. Chase • Susan Gibb • Timothy M. Cai
- چاپ و سال / کشور: 2011
Description
Purpose Transcutaneous electrical stimulation (TES) speeds up colonic transit in children with slow-transit constipation (STC). This study examined if concurrent upper gastrointestinal dysmotility (UGD) affected response to TES. Methods Radio-nuclear transit studies (NTS) were performed before and after TES treatment of STC as part of a larger randomised controlled trial. UGD was defined as delayed gastric emptying and/or slow small bowel transit. Improvement was defined as increase of C1 Geometric Centre (median radiotracer position at each time [small bowel = 1, toilet = 6]). Results Forty-six subjects completed the trial, 34 had NTS after stimulation (21 M, 8–17 years, mean 11.3 years; symptoms[9 years). Active stimulation increased transit in [50% versus only 25% with sham (p = 0.04). Seventeen children also had UGD. In children with STC and either normal upper GI motility (NUGM) and UGD, NTS improved slightly after 1 month (57 vs. 60%; p = 0.9) and more after 2 months (88 vs. 40%; p = 0.07). However, mean transit rate significantly increased with NUGM, but not UGD (5.0 ± 0.2: 3.6 ± 0.6, p\0.01).Conclusion Transcutaneous electrical stimulation was beneficial for STC, with response weakly associated with UGD. As measured by NTS, STC children with NUGM responded slightly more, but with significantly greater increased transit compared to those with UGD. Higher numbers are needed to determine if the difference is important.
Pediatr Surg Int (2011) 27:705–711 DOI 10.1007/s00383-011-2872-x Accepted: 15 December 2010 / Published online: 4 March 2011
