Effects of transcutaneous tibial nerve stimulation on anorectal physiology in fecal incontinence: a double‐blind placebo‐controlled cross‐over evaluation. Issue 2 (7th November 2013)

• Record Type: Journal Article
• Authors: Bouguen, G.; Ropert, A.; Lainé, F.; Pequin, P.; Morcet, J.; Bretagne, J.‐F.; Siproudhis, L.
• Is Part Of: Neurogastroenterology & motility. Volume 26:Issue 2(2014:Feb.)
• Page Start: 247
• Page End: 254
• Publication Date: 2013-11-07
• Subjects: Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.12256
• Languages: English
• ISSNs: 1350-1925

Abstract

<abstract abstract-type="main" id="nmo12256-abs-0001"> <title>Abstract</title> <sec id="nmo12256-sec-0001" sec-type="section"> <title>Background</title> <p>Transcutaneous electrical tibial nerve stimulation (TENS) is of growing interest for the treatment of fecal incontinence (FI), but its mechanism of action remains uninvestigated. We aimed to further assess the anorectal response to TENS in a dynamic model.</p> </sec> <sec id="nmo12256-sec-0002" sec-type="section"> <title>Methods</title> <p>We performed a placebo‐controlled, randomized, double‐blinded crossover study in 19 patients suffering from FI to assess the effects of TENS on anorectal function. Anorectal physiology and perception were recorded through two sequences of rectal isobaric distension using an electronic barostat device to measure anal and rectal pressures, rectal volumes, and perception scores.</p> </sec> <sec id="nmo12256-sec-0003" sec-type="section"> <title>Key Results</title> <p>Maximal rectal pressure and volume variation were affected by TENS, with higher mean maximal rectal pressure (5.33 and 4.06 mmHg in the active and sham TENS respectively, <italic>p</italic> < 0.0001) and lower volume variation (11.45 and 14.7 mL in the active and sham stimulation respectively, <italic>p</italic> < 0.05). Rectal compliance was not modified by active TENS. Pressure of the upper anal canal was significantly lower with raised isobaric distension in sequences assigned to active TENS.</p> </sec> <sec id="nmo12256-sec-0004" sec-type="section"> <title>Conclusions & Inferences</title> <p>Acute TENS modified anorectal physiology by strengthening the myogenic response to distension rather than increasing muscle relaxation and related rectal compliance in patients with FI.</p> </sec> </abstract>