Transcutaneous posterior tibial nerve stimulation improves bowel dysfunction in multiple sclerosis: LTP03

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Aim:Bowel dysfunction is common in multiple sclerosis but poorly understood and treated. Constipation and faecal incontinence often coexist. Spasticity of the pelvic floor has likely a role in bowel dysfunction as in bladder dysfunction. Posterior tibial nerve (PTN) transcutaneous electrical nerve stimulation (TENS) is already used in idiopathic faecal incontinence, overactive bladder, and is used in bladder spasticity in multiple sclerosis (MS).The aim of this work was to assess the efficiency of PTN TENS on bowel dysfunction in patients with MS.Method:Functional results of 19 patients with MS treated by PTN TENS (20 min a day; 10 Hz - 200 μs) were evaluated by Cleveland Clinic Constipation and Incontinence Scores (CCCS; CCIS) before and after treatment, and by subjective appreciation of treatment's effectiveness.Results:Sixteen patients were analyzed after a mean follow-up of 16 months (SE 8.1).The mean CCCS before and after TENS decreased significantly (11 vs 7; P = 0.022), as the mean CCIS in incontinent patients (9.4 vs 1.4; P = 0.002). Patients' perception was classified as cured (N = 3), improved (N = 8); no effect (N = 5).Conclusion:Transcutaneous posterior tibial nerve stimulation is a simple, non-invasive and low cost treatment which seems to improve bowel dysfunction in MS.

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