Percutaneous tibial nerve stimulation (PTNS) for chronic constipation
Research type
Research Study
Full title
The efficacy of percutaneous tibial nerve stimulation (PTNS) for chronic constipation: A single blind randomized placebo controlled trial.
IRAS ID
139247
Contact name
Carolynne Vaizey
Contact email
Sponsor organisation
Northwest London Hospitals NHS Trust
Research summary
Constipation (straining or difficulty when opening bowels or reduced frequency of bowel movements) is a common complaint which affects up to a third of the adult population. Constipation is extremely disabling and impacts upon an individual’s confidence and quality of life. The NHS also bears a significant financial burden, with the chronic use of laxatives, repeated GP and hospital clinic visits, costing millions each year. Treatment options seldom cure the vast majority of patients who are referred to specialist centres for further evaluation. Unfortunately, despite specialist behavioral therapies, up to 20% of patients remain symptomatic.
Newer developments have emerged in recent years which have shown promise as treatment options in chronic constipation. This includes nerve stimulation, whereby electrical pacemakers surgically implanted into the lower spine stimulate the nerves that control the bowel and rectum. These treatments can significantly improved symptoms of constipation and incontinence in up to 80% of patients. More recently we have demonstrated that electrical stimulation can be performed without the need for surgery. In our early trial involving 18 patients; electrical stimulation of the nerves in the lower leg, called percutaneous tibial nerve stimulation (PTNS), delivered through a small acupuncture needle, led to improvements in symptoms in almost two thirds of patients with constipation. This early trial demonstrated that PTNS is safe, tolerable by patients and easy to deliver in the outpatient setting.
The main aim of the current study is to investigate the efficacy of PTNS in a larger group of patients with constipation and compare it to a sham needle that looks the same but does not provide electrical stimulation.If successful, it may lead to improved and currently unavailable treatment options for patients who are unresponsive to conventional treatments.
REC name
London - Dulwich Research Ethics Committee
REC reference
14/LO/0214
Date of REC Opinion
22 Apr 2014
REC opinion
Further Information Favourable Opinion