FES for Constipation

Abdominal Electrical Stimulation for Chronic Constipation

Chronic constipation can cause infrequent bowel movements, hard stools, abdominal pain and bloating, affecting everyday life and wellbeing. It may occur alongside neurological conditions such as Multiple Sclerosis, spinal cord injury or Parkinson’s disease, and in people with constipation-predominant irritable bowel syndrome (IBS-C). Abdominal Functional Electrical Stimulation (FES) may help some people have more frequent bowel movements and reduce associated symptoms.
What is abdominal electrical stimulation?

 

FES uses a small battery-powered device and self-adhesive electrodes placed on the abdomen. The device delivers gentle electrical impulses to the nerves supplying the abdominal muscles.

 

How to access the service

You will need a referral from a healthcare professional, such as a GP, consultant, specialist nurse or physiotherapist.

 

 

Who may be suitable?

A history of chronic constipation, including reduced bowel movement frequency and / or hard stools.

 

Symptoms and current treatment have remained unchanged for at least three months before starting FES.

 

When treatment may not be suitable

• Previous abdominal surgery.
• Current or recent bowel obstruction.
• An indwelling abdominal device or tube, such as an intrathecal baclofen pump, PEG feeding tube, suprapubic catheter or flatus tube.
• Pregnancy or plans to become pregnant.
• Epilepsy that is not controlled with medication.
• A cardiac pacemaker or another active implanted medical device.
• Cancerous tissue in the abdomen or on the skin over the abdomen.
• Other bowel conditions, such as inflammatory bowel disease or coeliac disease; these will need individual discussion with the clinical team.

 

 

What treatment involves

If your referral is accepted, you will attend an initial face-to-face clinic assessment. During the appointment, the clinical team will discuss your symptoms and ask you to complete questionnaires. If FES is suitable, they will set up the device and show you how to use it at home. A partner or carer can also be taught to help where appropriate.

 

You will usually take the device home and use it for up to 30 minutes, twice a day, for six weeks. You will keep a bowel and treatment diary during this period.

 

A follow-up appointment will take place after six weeks, either in person or by telephone. The team will review your progress and repeat the initial questionnaires.

 

If your symptoms improve, you may continue using the stimulator on an adjusted schedule. Follow-up is normally offered at three months, six months and then annually while you continue using the device.

 

 

Preparing for your appointment

Please wear loose, comfortable clothing that allows the clinical team to access your abdomen to position the electrodes and assess whether FES is appropriate.

 

 

Contact the FES Service

For an information booklet or to discuss any concerns, contact the FES Service:

• 0121 466 3000 (Option 8)
• bchnt.fes@nhs.net