PWE-023 A prospective quasi-experimental pilot study comparing percutaneous tibial nerve stimulation and biofeedback treatment on slow transit and idiopathic constipation

Abstract

IntroductionThis quasi experimental pilot study compared percutaneous tibial nerve stimulation (PTNS) with biofeedback treatment to see whether PTNS is more effective for slow transit constipation (STC) and idiopathic constipation.MethodsTen female participants, 3 with STC and 7 with idiopathic constipation were recruited from gastroenterology clinics, with a mean age of 42.5 years (SD=7.0) and the patients were randomly allocated into two groups: one group had standard treatment (biofeedback) and the second group had PTNS.The following measures were recorded at baseline and after treatment: Patient Assessment of Constipation Quality of Life questionnaire (PAC-QOL), Hospital Anxiety and Depression Scale questionnaire (HADS), diary cards (constipation symptoms), anorectal physiology tests and a shape study (% colonic transit markers) for STC participants.The psychological measures were PAC-QOL and HADS questionnaires, the physiology measures were rectal sensation and rest and squeeze pressures and the symptom measures were diary cards. Descriptive statistics and a Wilcoxon matched pairs test looked at the within group data at baseline and after treatment. A Mann–Whitney U test was used to test for differences in the mean between the 2 groups.ResultThere were no differences found between the 2 treatment groups for all the diary cards, PAC-QOL, HADS and physiology tests measures (p value <0.05). The Wilcoxon test showed that there was a significant difference within group (p=0.05) between baseline and after treatment for the PTNS group for the total constipation score (PAC-QOL).ConclusionThis study indicates that PTNS significantly improves the total constipation quality of life score for slow transit and idiopathic constipation. Recommendations include carrying out a larger sample multi centre study in the future to see if PTNS is efficacious at improving constipation symptoms compared to biofeedback.