Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children

墨尔本皇家儿童医院有300多名患有慢性难治性便秘的儿童。我们有一种新的理疗技术，可以克服便秘，阻止其中许多儿童的污垢。在2003-2004年，我们进行了一项初步研究，以测试理疗师用于治疗尿失禁的技术。我们称这种方法为TESIC(干扰电流经皮电刺激)。TESIC使用放置在腹部和背部与肚脐水平的吸入电极。电刺激是利用电流(干扰电流)刺激腹部深处的。我们测试了8个孩子，结果非常令人鼓舞，5-8个孩子的便秘得到了改善，所有的污垢都停止了。家长和孩子都热衷于使用这项技术，但首先我们需要确定这一结果在70名儿童的更大范围内是可重复的。我们还需要知道这种效应是否只是一种安慰剂反应(由于与理疗师相处的时间)，以及这种效应持续了多长时间。我们还将衡量污垢的变化。粪便污垢是臭气熏天、反社会的。减轻污垢对孩子适应学校和正常上学的能力有很大影响。我们将使用孩子们每天写的日记、问卷、食物通过肠道的速度和肠道内的压力来衡量结果。我们拥有一支由经验丰富的临床医生和科学家组成的多学科团队，他们在这些技术和儿童便秘和失禁方面拥有专业知识(儿科外科医生、胃肠病专家、测压护士、失禁儿科医生和理疗师、电刺激专家和肠道神经系统科学家)。这种技术可能会给慢性便秘的治疗带来革命性的变化。大多数理疗师都有TESIC机器，可以在澳大利亚各地提供服务。它是非侵入性的，也应该能够被成年人使用，包括养老院的老年人。

We have over 300 children with chronic treatment-resistant constipation at Royal Children's Hospital Melbourne. We have a new physiotherapy technique that may overcome constipation and stop soiling in many of these children. In 2003-4, we ran a pilot study to test a technique used by physiotherapists to treat urinary incontinence. We have called the method TESIC (transcutaneous electrical stimulation using interferential current). TESIC uses suction electrodes placed on the belly and back at the level of the belly button. The electrical stimulation is applied using a current (interferential current) that stimulates deep into the abdomen. We tested 8 children and had very encouraging results with improved constipatio in 5-8 and all with soiling stopped. Parents and children are keen to use this technique but first we need to establish that the results are reproducible in a larger group of 70 children. We also need to know if the effect was just a placebo response (due to time spent with the physiotherapists), and how long the effect lasts. We will also measure changes in soiling. Faecal soiling is smelly and antisocial. Relief of soiling has a big impact on a child's ability to fit in at school and to attend normal schooling. We will measure outcomes using daily diaries kept by children, questionnaires, how quickly food moves through the bowel and pressures within the bowel. We have a multidiciplinary team of experienced clinicians and scientists with expertise in these techniques and in constipation and incontinence in children (paediatric surgeon, gastroenterologist, manometry nurse, incontinence paediatrician and physiotherapist, expert in electrical stimulation and gut nervous system scientist). This technique could revolutionise treatment of chronic constipation. Most physiotherapists have TESIC machines, allowing delivery Australia wide. It is non-invasive and should also be able to be used by adults, including the elderly in nursing homes.