The Use of SCS for the Pain of Irritable Bowel Syndrome
Alexander E. Yakovlev, MD, Angela M. Parmentier, APNP • Comprehensive Pain Management of the Fox Valley, SC 820 East Grant Street, Suite 335 • Appleton, Wisconsin, USA
Introduction:
Irritable bowel syndrome (IBS) is a disorder that leads to debilitating symptoms including abdominal pain and cramping and changes in bowel movements affecting approximately 1 in 6 people. As causes for this condition continue to evolve, studies have linked visceral hypersensitivity and spinal nociceptor hyperexcitability between the gastrointestinal system and nervous system.1 Described here is a reported case of improved abdominal pain and cramping with SCS in addition to regularity in bowel habits.
Methods:
A 44-year-old female was referred for evaluation of a 6-year history of IBS symptoms including abdominal pain, cramping, and irregularity in bowel habits. The patient expressed desire to decrease dependence on chronic opioid medication and maintain a quality of life. SCS neuromodulation trial was conducted with leads placed in the posterior epidural space at the level of T6, T7, T8 and T9. One lead was rested at the level of T6, T7, T8, and second lead at the level of T7, T8, T9.
Results:
SCS trial significantly alleviated the patient’s gastrointestinal symptoms and improved pain by 95%. Patient reports use of stimulator nearly 24 hours a day and adjusts stimulation as pain intensity varies and bowel habits changes. At three month follow-up, the patient has maintained improvement of gastrointestinal symptoms and decreased her opioid requirements. At five year mark, patient underwent replacement of generator and continues to report improved quality of life, remains on prn medication only, and reports bowel control with use of stimulation.
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Conclusion:
For patients with debilitating and intractable pain from IBS who are unresponsive to conservative management, SCS neuromodulation appears to be an effective therapy to control symptoms and improve one’s quality of life.
Reference:
Coffrin B, Bouhassira D, Sabate J, Barbe L, Jian R. Alteration of the spinal modulation of nociceptive processing in patients with irritable bowel syndrome. Gut: International Journal of Gastroenterology and Hepatology. 2004 October; 53(10): 1465–1470.
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