Transabdominal electrical stimulation increases colonic propagating pressure waves in paediatric slow transit constipation ☆,☆☆,★ Melanie C.C. Clarke a , Anthony G. Catto-Smith a,b,c , Sebastian K. King a,c , Phil G. Dinning d , Ian J. Cook d , Janet W. Chase a , Susan M. Gibb a,b , Val J. Robertson e , Di Simpson b , John M. Hutson b,c , Bridget R. Southwell a,c, ⁎ a Murdoch Childrens Research Institute, Melbourne, Australia b Royal Children's Hospital, Melbourne, Australia c Department of Paediatrics, University of Melbourne, Australia d St George Hospital, and Department of Medicine, University of New South Wales, Sydney, NSW e University of Newcastle, Australia Received 31 August 2012; accepted 1 September 2012 Key words: Interferential current; Colonic manometry; Transabdominal; Slow colonic transit Abstract Background and aims: In slow-transit constipation (STC) pancolonic manometry shows significantly reduced antegrade propagating sequences (PS) and no response to physiological stimuli. This study aimed to determine whether transcutaneous electrical stimulation using interferential current (IFC) applied to the abdomen increased colonic PS in STC children. Methods: Eight children (8–18 years) with confirmed STC had 24-h colonic manometry using a water-perfused, 8-channel catheter with 7.5 cm sidehole distance introduced via appendix stomas. They then received 12 sessions (20 min/3× per week) of IFC stimulation (2 paraspinal and 2 abdominal electrodes), applied at a comfortable intensity (b40 mA, carrier frequency 4 kHz, varying beat frequency 80–150 Hz). Colonic manometry was repeated 2 (n=6) and 7 (n=2) months after IFC. Results: IFC significantly increased frequency of total PS/24 h (mean±SEM, pre 78±34 vs post 210±62, p=0.008, n=7), antegrade PS/24h (43±16 vs 112±20, p=0.01) and high amplitude PS (HAPS/24 h, 5±2:10±3, p=0.04), with amplitude, velocity, or propagating distance unchanged. There was increased activity on waking and 4/8 ceased using antegrade continence enemas. ☆ Authors have no financial conflict of interest to disclose. ☆☆ Funding source: National Health and Medical Research Council, Australia (Project Grants 384434, 546432, Senior Research Fellowship 436916-BRS), Murdoch Childrens Research Institute Theme Investment Grants, and supported by the Victorian Government's Operational Infrastructure Support Program. ★ Ethics approval: Royal Children's Hospital Ethics Committee (HRC 23040 C), Clinical Trial Registration ANZCTR: ACTRN12610000418077. ⁎ Corresponding author. Gut Motility Laboratory, Surgical Research Group, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia, 3052. Tel.: +61 3 9345 5069. E-mail address: Bridget.Southwell@mcri.edu.au (B.R. Southwell). www.elsevier.com/locate/jpedsurg 0022-3468/$ – see front matter © 2012 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jpedsurg.2012.09.021 Journal of Pediatric Surgery (2012) 47, 2279–2284