Electrical Stimulation Effect in Constipated Patients with Impaired Rectal Sensation

Chang, Hye Sook; Myung, Seung Jae; Yang, Suk Kyun; Jung, Hwoon Yong; Kim, Tae Hoon; Yoon, In Ja; Kwon, Oh Ryoun; Hong, Weon Seon; Kim, Jin Ho; Min, Young Il

Abstract

BACKGROUND/AIMS: Among constipated patients, there is a subgroup of patients who complain about an absent or diminished sense of desire to defecate, suggesting that one of the causes of functional constipation may be impaired rectal sensation. Recently, electrical stimulation therapy (EST) has been used for the treatment of patients with urinary/fecal incontinence. The aim of this study was to evaluate the efficacy of EST for a subgroup of constipated patients with impaired rectal sensation.
METHODS
Of the 130 patients with functional constipation as defined by Rome II criteria, 22 patients who had impaired rectal sensation (rectal desire threshold volume = 90 ml) were selected. Twelve patients were treated with EST and 10 patients with biofeedback therapy (BFT).
RESULTS
The overall symptoms of the patients significantly improved after therapy in both groups (p<0.05). Interestingly, the sense of desire to defecate improved only after EST (p<0.05). Moreover, there was significant improvement in anal residual pressure after BFT solely (p<0.05). On the other hand, rectal sensory threshold volumes improved significantly after EST exclusively (p<0.05).
CONCLUSIONS
This study has revealed that the efficacy of EST can be comparable to BFT in a subgroup of constipated patients, especially with impaired rectal sensation. EST could be considered an adjunctive therapeutic modality for the management of functional constipation with impaired rectal sensation.