Dr Vivek Rajasekaran
The primary aim of this randomised, double blinded clinical controlled trial is to evaluate the efficacy of transabdominal electric stimulation (TES) in children with chronic constipation.
Chronic constipation is a common and challenging paediatric problem with no organic cause identified in the majority cases. A substantial proportion of children fail standard first line medical and behavioural therapy. Laxative therapy is also extremely challenging to administer to children with behavioural problems who often also have constipation. These children go on to have poor quality of life with significant developmental consequences arising from ongoing soiling accidents and functional abdominal pain. TES has been proposed as a novel therapy in the treatment of children with slow transit constipation. However, TES has not been evaluated on a heterogenous group of children with chronic idiopathic constipation.
In this trial, eligible patients with chronic idiopathic constipation presenting to an outpatient specialist paediatric service will be recruited and randomized to receive either home-based TES therapy or Sham therapy daily for 6 weeks. The primary outcome analyzed will be the number of complete spontaneous bowel motions(SBM) per week. Secondary outcomes analyzed include consistency of stools passed based on Bristol stool scale, number of soiling accidents and measures of quality of life based on the Neurogenic Bowel Dysfunction(NBD) Score.
Treatment of chronic idiopathic/functional constipation is challenging with a treatment failure rate up to 30% and up to 60% of children remaining on laxatives 3 years post treatment. Children also face significant psychological morbidities due to complications such as chronic abdominal pain and soiling.
With positive results from this trial, we hope to introduce TES as a novel non-invasive adjunctive treatment for children with treatment resistant constipation.