Efficacy of Cranial Electrotherapy Stimulation Combined with Biofeedback Therapy in Patients with Functional Constipation

Abstract

Background/AimsA large number of studies have shown that function constipation (FC) has an extremely high incidence of mental and psychological disorders. Cranial electrotherapy stimulation (CES) was applied to the treatment of psychological disorders such as anxiety and depression. We explored the effects of CES combined with biofeedback therapy (BFT) on the psychological state, clinical symptoms, and anorectal function in patients with FC. MethodsA total of 74 patients with FC were randomly divided into 2 groups. The control group received BFT. CES combined with BFT was carried out in the experiment group. All patients were assessed using the self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Wexner constipation score at baseline and the end of each course. Anorectal manometry and balloon expulsion tests were performed before and after treatment. ResultsAfter treatment, the participants in the experiment group had significantly lower score SAS, SDS, and Wexner constipation scores than the control group (all P < 0.05). The number of successful expulsion in the experiment group was larger than the control group (P = 0.016). Conclusions

Efficacy and Tolerability of Cranial Electrotherapy Stimulation in the Treatment of Anxiety: A Systemic Review and Meta-Analysis

“…In addition, 431 studies were excluded through full-texted assessment with specific reasons ( Supplementary Table S2 ). Ultimately, 11 studies were included ( Table 1 ) ( 11 – 13 , 21 , 22 , 24 , 26 , 42 , 50 – 52 ). The flowchart of our search strategy is presented in Figure 1 .…”

“…Furthermore, five out of six trials included in the study were published 20 years ago ( 10 , 11 , 16 – 19 ). After the United States Food and Drug Administration first approved CES devices for medical treatment in 1978, updated CES devices with enhanced technique have been marketed such as Alpha-Stim SCS, Alpha-Stim 100 and CMS generator ( 11 , 20 – 22 ). The distinct ability of newer devices provided more steady stimulation current, less variability of function, and thus more controllable effectiveness ( 23 ).…”

“…The distinct ability of newer devices provided more steady stimulation current, less variability of function, and thus more controllable effectiveness ( 23 ). In addition, several new double blinded RCTs have been published in more recent years ( 21 , 22 , 24 – 26 ). The design of double-blinded, sham controlled trials can eliminate the placebo effects both generated by the investigators and the subjects, minimizing the methodological heterogeneity that are commonly observed in the CES trials ( 20 , 27 ).…”

Cranial electrotherapy stimulation.

“…Four additional singleblind RCTs on anxiety yielded significant findings in favor of the treatment group (Chen et al, 2007;Gibson & O'Hair, 1987;Kim et al, 2008;Kolesos, Osionwo, & Akkhigbe, 2013). Four openlabel and retrospective analyses also reported that CES significantly decreased anxiety (Gong et al, 2016;Libretto, Hilton, Gordon, Zhang, & Wesch, 2015;x. y. Lu, Wang, Li, Zhang, & Liu, 2005;Overcash, 1999).…”

“…In addition, Chen et al (2007), in a singleblind, shamcontrolled RCT of 60 children ages 8 to 16 with mixed anxiety depression disorder, reported that CES significantly decreased depression (p < .001) in the treatment group, when compared with the sham group. Six openlabel studies and retrospective analyses reported that CES significantly decreased depression from base line to the endpoint of the study (Amr, ElWasify, Elmaadawi, Roberts, & ElMallakh, 2013;Bystritsky, Kerwin, & Feusner, 2008;Gong et al, 2016;Libretto et al, 2015;Lichtbroun, Raicer, & Smith, 2001;x. y. Lu et al, 2005).…”