Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$82,450.00
Summary
1 in 300 children suffer from chronic constipation that is not fixed by changing their diet or taking laxatives. They continue to suffer the problem into adulthood. They also have fecal incontinence or soiling that causes problems with socialising and schooling. We are testing a method of electrical stimulation through the skin on the belly to increase the movement of the bowel. Initial results are encouraging, showing that the rate of movement of the bowel is increased and soiling is decreased.
Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$346,995.00
Summary
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 ....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.Read moreRead less
A Multi-site Randomised Controlled Trial Comparing The Severity Of Constipation Symptoms Experienced By Palliative Care Patients Receiving Usual Care Compared To Those Diagnosed And Managed According To The Underlying Pathophysiology.
Funder
National Health and Medical Research Council
Funding Amount
$498,795.00
Summary
This research aims to consider whether the problems of constipation in palliative care are less severe when the physical changes that underlie the problem are explored.
Development Of The GUTSTIM Device For The Treatment Of Intractable Constipation
Funder
National Health and Medical Research Council
Funding Amount
$380,746.00
Summary
We have developed a new treatment for chronic constipation that uses electrical stimulation through the skin similar to physiotherapy treatments for sports injuries. 20 million people (3% of children and 20% of the elderly) have chronic constipation. This proposal is to develop a simple purpose-built machine that has the best electronic properties for stimulating the intestine. The machine will be simple, easy to use and cheap, allowing safe use at home by children and the elderly.
Over 80 million people have chronic constipation. It affects over 1/5 older people and is a major problem in aged-care. We have found that a painless method of electrical stimulation across the abdomen can overcome chronic constipation in children and adults. We will test the method to see what types of constipation it can help, including constipation caused by pain-medication and irritable bowel syndrome. This treatment is given at home and could improve life for many people around the world.
Stimulant laxatives are widely used and usually very effective in the short term, but how they work is very poorly understood. Our recent work has shown that they selectively excite sensory pathways from the colon which then trigger defaecation. This points to an undiscovered mechanism that potently affects colonic sensation and motility. This is likely to be a target for new treatments for other colonic disorders such as Irritable bowel syndrome and faecal incontinence.
Neuro-muscular Apparatus In Human Colon And In Children With Chronic Constipation
Funder
National Health and Medical Research Council
Funding Amount
$195,660.00
Summary
NIDKIDS is a support group for children with chronic constipation. There are 200 patients at the Royal Childrens Hospital in Melbourne who are in this group because their constipation has not responded to any treatments. Movement of food along the intestine requires muscle in the wall of the intestine to contract in a coordinated pattern. Coordination of the muscle contractions is provided by the nervous system. The nervous system controlling the gut has cell bodies located within the gut wall, ....NIDKIDS is a support group for children with chronic constipation. There are 200 patients at the Royal Childrens Hospital in Melbourne who are in this group because their constipation has not responded to any treatments. Movement of food along the intestine requires muscle in the wall of the intestine to contract in a coordinated pattern. Coordination of the muscle contractions is provided by the nervous system. The nervous system controlling the gut has cell bodies located within the gut wall, that send processes to the muscle and lining of the gut. There are sensory neurons, motor neurons and neurons that connect between the other neurons (interneurons). Nerves communicate between each other and cause muscles to contract by releasing chemicals (transmitters). In the last decade, we have discovered that communication between the nerve and muscle cells occurs through a third cell type- interstitial cells of Cajal. These cells also have a role as pacemaker cells for the muscle cells. In a small study, we have found that the muscle can contract in response to transmitters but that activation of the nerves does not result in muscle contraction in NIDKIDs. This result shows that transmission from neurons to muscle is not occuring in large bowel from NIDKIDs. In this study, we will examine a larger group of patients to determine if a functional defect in the muscle, a defect in the nerve chemical transmitters or a lack of the intermediate cells (the interstitial cells of Cajal) is causing the problem in the NIDKIDs. Further treatment of each patient will be easier if the defect causing his-her problem is known. We would then be able to target their problem with drugs that would work specifically at the point of breakdown in their individual gut.Read moreRead less
I am a neuroscientist translating basic knowledge on the enteric nervous system into new therapies for children with previously untreatable bowel motility disorders. I am heading a multidisciplinary group of clinicians and scientists leading the world in