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Nerve stimulation may relieve fecal incontinence

SurgeryNov 29, 05

Sacral nerve stimulation appears to be an effective treatment for fecal incontinence, the leakage of feces from the bowel, and the benefit is apparently not due to a “placebo effect,” according to the results of a study conducted by French researchers.

This is the first study to examine “the effectiveness of sacral nerve stimulation in a significant number of fecally incontinent patients,” lead author Dr. Anne-Marie Leroi, from Hopital Charles Nicolle in Rouen, and colleagues note.

The study, which appears in the Annals of Surgery, involved 34 consecutive patients with fecal incontinence who were treated with sacral nerve stimulation using a standard implantable device. The procedure involves the implantation of a small device that sends electronic signals to the nerves connected to the lower back. These signals help stabilize the bowel and prevent incontinence.

Twenty-seven of the patients were randomly assigned to stimulation turned “on” or “off” for one-month periods, without knowing which mode the device was in.

The subjects were asked to select which period they preferred. The on periods were associated with a significant reduction in fecal incontinence episodes compared with the off periods, the report indicates. Moreover, patients reported greater improvements during the on period and preferred this period over the off period.

In the last portion of the study, the subjects continued therapy for 3 months in their selected stimulator position. Once again, a drop in incontinence episodes was noted among subjects who selected the on position.

Other benefits tied to active stimulation included improved postponement of defecation, a drop in symptom severity, improvements in quality of life, and better anal sphincter function.

“Our trial has shown that the clinical benefit derived from sacral nerve stimulation was not due to a placebo effect and has confirmed the short-term efficacy of this technique on continence and the quality of life in patients with fecal incontinence,” the authors conclude.

SOURCE: Annals of Surgery, November 2005.

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