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Seniors' Health: Nerve stimulation eases tough-to-treat constipation

Implanted device doubles the number of weekly bowel movements in a European study

People with longstanding constipation that hasn't responded to medication may benefit from an implanted device that stimulates the nerves of the lower bowel.

This alternative approach, called sacral nerve stimulation, was tested in a European study of 65 people whose constipation hadn't been relieved by laxatives or other treatments. On average, the study participants had no more than two bowel movements per week.

The patients were implanted with a device that includes a thin insulated wire and a nerve stimulator similar to a heart pacemaker. The device, which is about the size of a pocket stopwatch, is inserted under the skin of the upper buttock. Thin wires run continuous low-level electrical stimulation to the nerve supplying the lower bowel and sphincter.

In the first part of the study, the device was tested on a temporary basis in all the study participants. About two-thirds showed a 50 per cent improvement in their symptoms and were eligible for permanent implantation. Over the next year, frequency of defecation in these 43 patients nearly doubled, increasing from three to six bowel movements per week. A quality-of-life questionnaire also revealed significant improvements.

Although constipation is rarely life-threatening, the symptoms of abdominal pain and bloating can severely affect the physical and emotional well-being of the 15 per cent of people worldwide who suffer from it, says lead study investigator Dr. Thomas Dudding of St. Mark's Hospital in London.

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