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Abstract
Aim: Functional constipation is common in multiple sclerosis (MS) and first line treatments are frequently ineffective. The current study explored the use of abdominal functional electrical stimulation (ABFES) for treating constipation in MS. Patients/methods: 20 people with MS and constipation (ROME IV criteria). The patient assessment of constipation-related quality of life questionnaire was administered at baseline and after 6 weeks of ABFES treatment alongside semi-structured interviews. Results: All patient assessment of constipation-related quality of life subscales were significant: satisfaction (p = 0.003), psychosocial discomfort (p = 0.008), physical discomfort (p = 0.001) and worries and concerns (p = 0.003). A long-term therapeutic effect, reduction in laxative use and improved sexual functioning were also reported. Conclusion: ABFES provides a potential alternative treatment intervention for people with MS and constipation.
Lay abstract
Constipation is common for people with multiple sclerosis and treatments are often ineffective. This study used electrical stimulation of the abdominal muscles to treat constipation in people with multiple sclerosis. The success of the treatment was measured through a questionnaire about quality of life related to constipation. Some people reported a long-term benefit after they had stopped using the electrical stimulation, reduced use of laxatives and improved sexual functioning.
Supplementary data
To view the supplementary data that accompany this paper please visit the journal website at:www.tandfonline.com/doi/full/10.2217/nmt-2018-0043
Acknowledgments
P Taylor from Salisbury NHS Foundation Trust and Odstock Medical provided training, advice and support on using the stimulators at the Salisbury site and reviewed a draft of the study in Salisbury. S Vyas consultant gastroenterologist from Salisbury NHS Foundation Trust provided advice on classifying functional constipation and standard care. I Swain from Odstock Medical approved the loan of five free stimulators and consumables for patients seen in Salisbury and reviewed an earlier draft of the study in Salisbury.
Author contributions
T Street contributed substantially to the conception and design of the work, analysis and interpretation of the data, drafting the work and revising it critically for intellectual content, contributed to acquisition of data. Final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. C Singleton contributed substantially to the conception and design of the work, contributed substantially to acquisition of data, contributed to interpretation of the data and contributed to revising the work for intellectual content. Final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. C Peace contributed substantially to acquisition of the data for the study, contributed to revising the work for intellectual content. Final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. E Padfield contributed to acquisition of the data for the study, contributed to initial analysis of the data and revising the work for intellectual content. Final approval of the version to be published and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Financial & competing interests disclosure
Odstock Medical Ltd provided stimulators and consumables for five participants included in the study free of charge. All other stimulators, consumables and treatment was funded by the UK National Health Service. The first author completed the work on a grant from Salisbury Charitable Trust. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.
Ethical disclosure
The authors state that they have obtained appropriate institutional review board approval and have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.