D F Altomare1,2, A Picciariello3, A Di Ciaula4, M Rinaldi3, M De Fazio3, P Portincasa5. 1. Department of Emergency and Organ Transplantation, University "Aldo Moro", Bari, Italy. donatofrancesco.altomare@uniba.it. 2. IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy. donatofrancesco.altomare@uniba.it. 3. Department of Emergency and Organ Transplantation, University "Aldo Moro", Bari, Italy. 4. Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University "Aldo Moro", Bari, Italy. 5. Department of Biomedical Sciences and Human Oncology, Clinica Medica "A. Murri", University "Aldo Moro", Bari, Italy. piero.portincasa@uniba.it.
Abstract
BACKGROUND: The efficacy of sacral nerve stimulation (SNS) on patients with chronic refractory slow-transit constipation is controversial and its mechanism of action on gastrointestinal motility and transit is not fully understood. The aim of this study was to document the effects of temporary SNS on the gastrointestinal and biliary tract motility and on gastrointestinal transit in patients with refractory slow-transit constipation. METHODS: This was a prospective interventional study. Patients with slow-transit chronic constipation, unresponsive to any conservative treatment, were enrolled between January 2013 and December 2018. Patients' quality of life [patient assessment of constipation quality of life (PAC-QOL) questionnaire], constipation scores (Cleveland Clinic Constipation Score) colonic transit time (CTT), orocecal transit time (OCTT), gastric and gallbladder kinetics, together with the assessment of the autonomic nerve function were evaluated before and during temporary SNS. RESULTS: 14 patients (12 females, median age 38 years, range 24-42 years) had temporary SNS. The Cleveland Clinic Constipation Score did not change compared to baseline (23 ± 3 vs 21.4; p = 070). The PAC-QOL did not improve significantly during the stimulation period. Gallbladder/stomach motility (half-emptying time) did not change significantly before and after SNS. OCTT was delayed at baseline, as compared to standard internal normal values, and did not change during SNS. CTT did not improve significantly, although in two patients it decreased substantially from 97 to 53 h, and from 100 to 65 h. CONCLUSIONS: Temporary SNS did not have any effect on upper/lower gastrointestinal motility and transit in patients with severe constipation.
BACKGROUND: The efficacy of sacral nerve stimulation (SNS) on patients with chronic refractory slow-transit constipation is controversial and its mechanism of action on gastrointestinal motility and transit is not fully understood. The aim of this study was to document the effects of temporary SNS on the gastrointestinal and biliary tract motility and on gastrointestinal transit in patients with refractory slow-transit constipation. METHODS: This was a prospective interventional study. Patients with slow-transit chronic constipation, unresponsive to any conservative treatment, were enrolled between January 2013 and December 2018. Patients' quality of life [patient assessment of constipation quality of life (PAC-QOL) questionnaire], constipation scores (Cleveland Clinic Constipation Score) colonic transit time (CTT), orocecal transit time (OCTT), gastric and gallbladder kinetics, together with the assessment of the autonomic nerve function were evaluated before and during temporary SNS. RESULTS: 14 patients (12 females, median age 38 years, range 24-42 years) had temporary SNS. The Cleveland Clinic Constipation Score did not change compared to baseline (23 ± 3 vs 21.4; p = 070). The PAC-QOL did not improve significantly during the stimulation period. Gallbladder/stomach motility (half-emptying time) did not change significantly before and after SNS. OCTT was delayed at baseline, as compared to standard internal normal values, and did not change during SNS. CTT did not improve significantly, although in two patients it decreased substantially from 97 to 53 h, and from 100 to 65 h. CONCLUSIONS: Temporary SNS did not have any effect on upper/lower gastrointestinal motility and transit in patients with severe constipation.
Authors: D F Altomare; S Giuratrabocchetta; C H Knowles; A Muñoz Duyos; J Robert-Yap; K E Matzel Journal: Br J Surg Date: 2015-02-02 Impact factor: 6.939
Authors: D F Altomare; P Portincasa; M Rinaldi; A Di Ciaula; E Martinelli; A Amoruso; G Palasciano; V Memeo Journal: Dis Colon Rectum Date: 1999-02 Impact factor: 4.585
Authors: Bernhard Widmann; Christian Galata; Rene Warschkow; Ulrich Beutner; Önder Ögredici; Franc H Hetzer; Bruno M Schmied; Stefan Post; Lukas Marti Journal: J Neurogastroenterol Motil Date: 2019-01-31 Impact factor: 4.924