Long-term effects of transabdominal electrical stimulation
in treating children with slow-transit constipation
Leanne C.Y. Leong
, Yee Ian Yik
a, c, g
, Anthony G. Catto-Smith
Val J. Robertson
, John M. Hutson
, Bridget R. Southwell
a, c, d,
Surgical Research Group, Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
Department of Medicine, University of Melbourne, Melbourne, VIC 3010, Australia
Department of Paediatrics, University of Melbourne, Melbourne, VIC 3010, Australia
Department of Gastroenterology and Nutrition, Royal Children's Hospital, Melbourne, VIC 3052, Australia
Department of Urology, Royal Children's Hospital, Melbourne, VIC 3052, Australia
University of Newcastle, Newcastle, NSW 2300, Australia
Department of General Surgery, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
Received 24 August 2011; accepted 3 September 2011
Aims: Transcutaneous electrical stimulation (TES) was used to treat children with slow-transit
constipation (STC) for 1 to 2 months in a randomized controlled trial during 2006 to 2008. We aimed to
determine long-term outcomes, hypothesizing that TES produced sustained improvement.
Methods: Physiotherapists administered 1 to 2 months of TES to 39 children (20 minutes, 3 times a
week). Fifteen continued to self-administer TES (30 minutes daily for more than 2 months). Mean long-
term follow-up of 30 of 39 patients was conducted using questionnaire review 3.5 years (range 1.9-4.7
years) later. Outcomes were evaluated by confidence intervals or paired t test.
Results: Seventy-three percent of patients perceived improvement, lasting more than 2 years in 33% and
less than 6 months in 25% to 33%. Defecation frequency improved in 30%. Stools got wetter in 62%
after stimulation and then drier again. Soiling improved in 75% and abdominal pain in 59%. Laxative
use stopped in 52%, and 43% with appendicostomies stopped washouts. Soiling/Holschneider
continence score improved in 81% (P = .0002). Timed sits switched to urge-initiated defecations in 80%
patients. Eighty percent of relapsed patients elected to have home stimulation.
Conclusion: TES holds promise for STC children. Improvement occurred in two thirds of children, lasting
more than 2 years in one third, whereas symptoms recurred after 6 months in one third of children.
© 2011 Elsevier Inc. All rights reserved.
Constipation affects 3% of children, with a third of these
developing chronic constipation [1-3]. Chronic constipation
can be categorized into separate groups including those with
normal proximal transit but hold-up at the anorectum
(anorectal retention/functional fecal retention) and those
with delayed colonic transit (slow-transit constipation, STC).
Presented at the Pacific Association of Pediatric Surgeons 44th Annual
Meeting, Cancun, Mexico, April 10-14, 2011.
Corresponding author. Surgical Research Group, Murdoch Children's
Research Institute, Royal Children's Hospital, Parkville, VIC 3052,
Australia. Tel.: +61 3 9345 5069; fax: +61 3 93457997.
E-mail address: firstname.lastname@example.org (B.R. Southwell).
0022-3468/$ – see front matter © 2011 Elsevier Inc. All rights reserved.
Journal of Pediatric Surgery (2011) 46, 2309–2312