Three‐year follow‐up of sacral nerve stimulation for patients with diarrhoea‐predominant and mixed irritable bowel syndrome

• Published in: Colorectal disease 2017-02, Vol.19 (2), p.188-193
• Main Authors: Fassov, J., Lundby, L., Laurberg, S., Buntzen, S., Krogh, K.
• Format: Article
• Language: English
• Subjects: Adult; Diarrhea; Diarrhea - etiology; Diarrhea - therapy; Electric Stimulation Therapy - methods; Female; Follow-Up Studies; follow‐up; Humans; IBS symptoms; Intestine; Irritable bowel syndrome; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - therapy; Lumbosacral Plexus; Male; Middle Aged; Quality of life; Randomized Controlled Trials as Topic; sacral nerve stimulation; Sacrum; Stimulation; Treatment Outcome; Young Adult
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.13428

Aim Our unit has recently shown that sacral nerve stimulation (SNS) has a significantly positive short‐term effect on selected patients with diarrhoea‐predominant or mixed irritable bowel syndrome (IBS). The aim of the present prospective study was to evaluate the medium‐term efficacy of SNS for IBS to establish whether SNS could have a future role in the treatment of IBS. Method Patients with IBS who had previously been implanted with a permanent neurostimulator as part of a randomized, controlled, crossover study, were assessed for medium‐term follow‐up. The primary end‐point was change in the IBS‐specific symptom score (Gastrointestinal Symptom Rating Scale–Irritable Bowel Syndrome version questionnaire) from baseline to 3‐year follow‐up. The secondary end‐point was a change in the IBS‐specific quality of life score (Irritable Bowel Syndrome–Impact Scale questionnaire) from baseline to 3‐year follow‐up. Results Of 26 patients, 20 were eligible for 3‐year follow‐up. The median IBS‐specific symptom score was significantly lower at 3‐year follow‐up (30, range 13–71) than at baseline (62, 45–80) (P = 0.0001). The effect was observed in all symptom clusters within the score. Also, the median IBS‐specific quality of life score was significantly improved at 3‐year follow‐up (52, 26–169) compared with baseline (135, 82–180, P = 0.0002). The effect was observed in all domains of the score. As per the protocol, 75% of patients were judged therapeutic successes. Seventy per cent of patients had a more than 50% reduction in daily IBS symptoms. Conclusion At medium‐term follow‐up, SNS continues to be an effective treatment for highly selected patients with diarrhoea‐predominant or mixed IBS.