Afferent Stimulation to Evoke Recto-colonic Reflex for Colonic Motility
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Neurogenic Bowel Dysfunction
- Sponsor
- VA Office of Research and Development
- Enrollment
- 2
- Locations
- 2
- Primary Endpoint
- Compare Changes in Number of Interventions Used to Complete Bowel Routine, Including Electrical Rectal Stimulation (Treatment) Versus Mechanical Rectal Distension (Control)
- Status
- Completed
- Last Updated
- 2 years ago
Overview
Brief Summary
The investigators are testing the effect of electrical stimulation of the rectum on colonic motility. Most individuals with spinal cord injury develop neurogenic bowel dysfunction, which includes slowed colonic motility, which means that stools take longer than normal to pass through the colon. This slowed movement may result in chronic constipation and difficulty emptying the bowels. Individuals typically (without or without caregiver assistance) insert a gloved finger into the rectum and gently stretch it to improve colonic motility for a brief period to empty the bowels. The investigators hypothesize that electrically stimulating the rectum, instead of mechanically stretching it, will produce the same beneficial effect of improving colonic motility. Therefore, this study will compare the two methods. If electrical stimulation effectively improves colonic motility, then the investigator shall develop the approach as a therapeutic intervention in future studies.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Diagnosed neurogenic bowel dysfunction and using digital rectal stimulation
- •Neurologically stable
- •Skeletally mature
- •Suprasacral spinal cord injury, stroke, or multiple sclerosis
- •At least 6 months post neurological injury or disease diagnosis
Exclusion Criteria
- •Active sepsis
- •Open pressure sores on or around pelvis
- •Significant colon trauma or colostomy
- •History of autonomic dysreflexia
Outcomes
Primary Outcomes
Compare Changes in Number of Interventions Used to Complete Bowel Routine, Including Electrical Rectal Stimulation (Treatment) Versus Mechanical Rectal Distension (Control)
Time Frame: 1 month
Two interventions will be tested, including the clinical standard of digital rectal stimulation and a novel approach using electrical stimulation of rectal sensory afferents, to determine the effect on colonic pressure. Typically several bouts of digital rectal stimulation are required to achieve complete bowel emptying. We will compare the number of bouts of digital rectal stimulation (control) with electrical rectal stimulation (treatment) required to achieve complete bowel emptying.