Transcutaneous electrical acustimulation effective in IBS with constipation

Patients with irritable bowel syndrome (IBS) and constipation (IBS-C) can improve their symptoms by undergoing transcutaneous electrical acustimulation (TEA), suggests a study. TEA speeds up colon transit and reduces rectal sensation, which is potentially mediated by using the autonomic mechanisms.

Fifty-two patients with IBS-C were randomly assigned to receive daily TEA for 4 weeks (n=26) or daily sham TEA for 4 weeks (n=26). The authors assessed the number of complete spontaneous bowel movements per week (CSBM/week), Irritable Bowel Syndrome Severity Scoring System (IBSSSS), Patient Assessment of Constipation Quality of Life (PACQoL), visual analogue scale (VAS) pain score, colonic transit time, and anorectal physiology before and at the end of treatment.

Radiopaque markers were used to examine colonic transit, and electrocardiograms were recorded to assess autonomic functions.

TEA resulted in improvements in constipation and abdominal pain. The number of CSBMs/week during the last week was higher in the TEA group than in the sham TEA group (3.5 vs 0.6; p=0.002). These effects were also observed in the VAS pain score (p=0.002) and IBSSSS score (p=0.025). A significant improvement was also noted in the quality of life of patients with constipation. The PACQoL total score was markedly reduced in the TEA cohort (p=0.004).

In addition, TEA improved colon transit (p=0.002) and raised the threshold of rectal sensation (desire to defecate; p=0.004; maximum tolerability; p<0.001) relative to sham treatment. Notably, TEA also increased vagal activity (p<0.05), which was significantly associated with colon transit and CSBMs/week compared with sham TEA.

“Slow colon transit and visceral hypersensitivity are recognized as major pathophysiological mechanisms in IBS-C,” the authors said.