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13 UNITED EUROPEAN GASTROENTEROLOGY WEEK
Copenhagen 15-19 October 2005
Associazione Cattolica per lo Sviluppo della
Ricerca nelle Terapie Riabilitative ONLUS
UNIVERSITA CATTOLICA DEL SACRO CUORE FACOLTA
DI MEDICINA E CHIRURGIA AGOSTINO GEMELLI
CHRONIC CONSTIPATION RESULTS OF A CLINICAL
OBSERVATION IN THE USE OF FRE.M.S. (FREquency
Modulated neural Stimulation) THERAPY. PILOT
STUDY. Massari M , Zanella A., Desideri
P., Rando G., Wiel Marin A.
Dep.Surgical Sciences, U.O.C. General Surgery
1, Catholic University S. Heart-Columbus Hospital
Rome Lorenz Biotech, Medolla, Modena ?
Ce.Te.Ri. Rehabilitation Therapy Centres, Onlus,
Rome


  Introduction. Chronic constipation and his
symptomatological aspects, assumes a pathological
role of social interest entailing high costs.
Pharmacological multidrug therapies are often
ineffective. The motility function, immune
modulation, enteric sensibility, permeability of
the mucosal and the submucosal vascular system,
proliferation and activities of the
enterochromaffin cells, are subject to autonomous
control of the Enteric Nervous System (ENS) and
its interrelation with the Central Nervous System
(CNS) through the Autonomous Nervous System
(ANS). The interaction of this neuronal systems
occurs through electrical signals, generated by
transmembrane action potentials.
Aim of the study. We have conduct a pilot study
with clinical observation, to evaluate the
effects on regularization of the colon motility,
through administration a transcutaneous
negative asymmetrical electrical pulse patterns.
Materials and methods. We selected
15 patients with chronic constipation (interval
between evacuations on average 9 days (6-12), and
partial spontaneous evacuations or induced by
monodrug or multidrug cholagogues therapy),
excluding the presence of organic or inflammatory
diseases, outflow disfunction and defecatory
disorders. All patients underwent at cycle of 15
FRE.M.S. therapy (F.T.) sessions, at fixed and
variable frequency (software controlled). The
electric fields, generated by ETS 501
neurostimulator machine (Lorenz Biotech,Italy),
has been administered using two methods on the
ascending, transverse and descending colon
segments, with fixed frequency (400 Hz, duration
30-40 µseconds, amplitude 70-250 Volts, patient
controlled through remote control /-1Volt) on
the sigmoid tract with variable frequency (1-100
Hz, pulse duration 10-90 µseconds, amplitude
70-250 Volts patient controlled through remote
control). Results. On all the patients we
obtained spontaneous regularization of the bowel
habit, daily or tri-weekly (6 cases), bi-weekly
(8 cases). On one case a second therapy cycle was
necessary to obtain spontaneous tri-weekly
evacuations. The follow-up of 12 months, proved
that the frequency of evacuation could be
maintained for 6-8 months without clinical
symptomatology and without cholagogues use.
Conclusions. This clinical observation allows us
to assume that particular electrical signal
patterns at variable frequency, amplitude and
duration, may allow produce an
electro-physiological interaction with the
neuronal systems (so called BGA), which governs
the colon functions. On an ensuing protocol we
will study which neurohistological and
immunohistochemical modifications may be induced
by electric fields generated by this type of
pulse.
CTT at 24h after marker ingestion
CTT control after 5 days
risoluzione schermo consigliata 1024 x 768 pixel
pelvic muscles basal tone maximal
contraction pelvic muscles tone
Key words constipation, electric stimulation,
enteric nervous system Abbreviations FRE.M.S.,
FREquency Modulated neural Stimulation ENS,
enteric nervous system ANS, autonomous nervous
system CNS, central nervous system BGA, brain
gut axis Corresponding author Massimo Massari
M.D. Catholic University of S. Heart-Columbus
Hospital Rome V. G. Moscati 31, 00168 Rome
Italy Tel/Fax [phone] e-mail
massimo.massari_at_virgilio.it
FRE.M.S. therapy application