The effectiveness of transcutaneous nerve stimulation in treating children with functional constipation

Background and study aims: Functional constipation (FC) is a prevalent condition in paediatric populations and while standard therapies, including laxatives and toilet training are commonly used, a substantial proportion of children exhibit an inadequate response. This study aimed to evaluate the effectiveness of transcutaneous nerve stimulation (TENS) as a non-invasive treatment for FC in children.

Patients and methods: Children diagnosed with FC according to the Rome IV criteria and treated with TENS were included in this retrospective cohort study. Data were collected in two Belgian hospitals between 2018 and 2024. Primary outcome measures included stool frequency, stool retention behaviour, faecal incontinence, and stool size. Statistical analyses incorporated post hoc comparison with Bonferroni correction.

Results: A total of 36 children were included (median age 7.5 years, range 3–15 years; 61% male) of whom approximately one-third had a concomitant diagnosis of a neurodevelopmental disorder (NDD). Improvements were observed in faecal incontinence (p = 0.016), retentive behaviour (p = 0.001), stool frequency (<2 bowel movements/week) (p = 0.035), and abdominal pain (p = 0.006). After applying a Bonferroni correction, only the effect on retentive behaviour remained statistically significant. Side effects were limited to mild erythema in two patients, which did not necessitate discontinuation.

Conclusion: TENS appears to be a promising and well-tolerated treatment for children with FC and it may be considered as an early intervention within the therapeutic management pathway as the beneficial effects seem particularly evident in children with more severe forms.

Keywords: functional constipation, TENS, neuromodulation, Rome IV criteria.