Clinical Trial: Transcutaneous Interferential Electrical Stimulation in Individuals with Irritable Bowel Syndrome – A Prospective Double-Blind Randomized Study

Abstract

Background: The exact etiology of irritable bowel syndrome (IBS) remains unclear. Curative treatment is not available and current treatment modalities are mainly directed against the predominant symptoms. There are a few studies reporting the beneficial effects of transcutaneous electrical stimulation in patients with chronic constipation, gastroparesis, and functional dyspepsia. Aim: To investigate whether transcutaneous electrical stimulation is an effective procedure in IBS patients. Methods: IBS patients were randomly placed in vacuum interferential current (IFC) and placebo groups. Both treatments consisted of 12 sessions administered over 4 weeks. Symptoms due to IBS were documented via questionnaires, including the IBS Global Assessment of Improvement Scale, numeric rating scales, visual analogue scale, and IBS Quality of Life Scale at the beginning of, end of, and 1 month after the treatment. Results: Patients in the therapy (29 cases) and placebo (29 cases) groups were homogeneous with respect to demographic data and gastrointestinal system symptoms. When compared to the beginning scores, severity of abdominal discomfort, bloating, and abdominal distension and rumbling improved significantly in either interference or placebo groups at both the end of treatment and 1 month after treatment. In the IFC group, severity of symptoms continued to decrease significantly at 1 month after treatment when compared to scores at just the end of treatment, whereas in the placebo group severity of these symptoms did not change significantly on numeric severity scales. Also, the visual analogue scale of the first month after treatment continued to decrease significantly when compared to the level at the end of treatment in the IFC group. Total quality score increased significantly in the IFC group. Conclusions: Vacuum IFC therapy can significantly improve symptoms and quality of life in patients with IBS. It may represent a novel treatment modality for drug-refractory IBS patients.

Neuromodulation via Interferential Electrical Stimulation as a Novel Therapy in Gastrointestinal Motility Disorders

“…Sham stimulation was the absence of any current, but suction cups were placed according to the study design, and still connected to the stimulating machine in the same way as active therapy, but not switched on. 47,48 In both studies, treatment was administered by a physiotherapist 3 times a week for 4 weeks.…”

“…A strong placebo response was noted in both studies with no clear difference between the significant improvements from baseline in the real or placebo arms. 47 There was also a moderate participant dropout rate, possibly related to the exclusion of rescue medication. In addition, each study was at risk of responder bias as the questionnaires were administered by the study physiotherapists.…”

Medical devices to deliver transcutaneous electrical stimulation using interferential current to treat constipation

“…When used for urinary incontinence, TES also produced diarrhea, leading physiotherapist Janet Chase, who specialized in incontinence, to test TES on children with chronic constipation [6]. Since that study, published in the year 2005, IFC has been used to treat a number of bowel motility disorders including dyspepsia [7], irritable bowel syndrome [8], slow transit constipation in children [9][10][11][12][13][14] and adults [11] and constipation in children with myelomeningocele (a type of spina bifida) [15]. In the colon, TES-IFC increased the colonic motility, sped up colonic transit, increased the sensation of the urge to defecate, increased the defecation frequency and reduced soiling and bloating.…”

“…This device is available in Australia and UK. Other groups have used NOVIN model 510 A (Isfahan, Islamic Republic of Iran) [15,18] and Ito EU-940 (Germany) [8] with good results. A comparison among the output of the devices would be useful.…”

“…Electrodes can be long-use types made of carbon rubber and used with suction [8] or with wet sponge pads [6] or can be silicon-coated disposable electrodes [13]. Different sizes have been used including 2.3 Â 3.5 cm and 4 Â 4 cm.…”