Chronic Constipation Ameliorated by Thoracic Spinal Cord Stimulation

TL;DR

A man with chronic constipation and abdominal pain found relief through spinal cord stimulation, suggesting a new treatment approach.

Contribution

This case introduces thoracic spinal cord stimulation as a potential therapy for chronic constipation.

Findings

Thoracic spinal cord stimulation reduced chronic abdominal pain and constipation in a patient with cerebral palsy.

Low-frequency stimulation induced abdominal twitching and provided long-term relief.

The results suggest a novel neuromodulation therapy for chronic constipation.

Abstract

A male in his mid-50s with a history of cerebral palsy was referred to the neurosurgical department for the management of chronic abdominal visceral pain after nine years of suffering. He had refractory constipation in his youth. Following a permanent colostomy for intestinal obstruction, visceral pain emerged over the right abdominal area, which became refractory to medication. Spinal cord stimulation (SCS) was performed with a pair of electrodes placed over the right mid-dorsal column between the T11-12 segments. Low-frequency stimuli with enough intensity to induce abdominal twitching reduced pain and relieved constipation for at least one year’s follow-up. As the effects were strong and persistent, our findings suggest a novel neuromodulation therapy for chronic constipation. However, clinicians should be aware of the potential risk of unwanted gastrointestinal symptoms when thoracic SCS is performed.

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