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We can work it out: Good vibrations for researchers in the quest for drug-free constipation treatment

By Dr Doug Witherspoon - 01st May 2023

constipation

Whatever the patient’s age, constipation can raise its ugly head and make life utterly miserable. This is particularly the case for that vulnerable cohort who are suffering with constipation due to cancer medications, and for whom polypharmacy could be a problem when it comes to adding more meds.

Of course, lifestyle and dietary changes may be impossible for people with comorbidities and a multi-drug regimen. There are some good medical solutions on the market for constipation, but for complex patients, sometimes an effective drug-free alternative would be more desirable.

This was front-and-centre in the minds of researchers from the Medical College of Georgia at Augusta University, US, who have recently developed a vibrating capsule especially to fill that therapeutic space.

Initial results from trials of the vibrating capsules, which contain no active ingredients, show that they double the ability of adults with chronic constipation to achieve more normal bowel movements. The capsule itself is shaped like a traditional pill and is almost one inch long and contained in a latex-free plastic shell. Designed to be taken five days a week twice-daily, the capsules are pre-programmed to create two-hour ‘vibration sessions’, stimulating the colon for three seconds, followed by 16 seconds of non-activity.

When its job is done following two daily ‘sessions’, the capsule becomes dormant and is passed through the GI tract in the normal way.

The research involved 90 clinics nationally, with 300 participants. Those in the study used the vibrating capsules for two months and the researchers found that the participants using the capsule had approximately double the amount of spontaneous bowel movements compared to those who took placebo.

And of course, there is the gut-brain connection – some of the evidence suggests that the increased activity in the colon caused by the capsule is picked up in the brain and, in time, it is hoped that the brain may be ‘trained’ to replicate the effects without the aid of the capsule.

There was a marked improvement in stool consistency, straining, and overall quality-of-life compared to the placebo cohort. Side-effects were almost nil, with 11 per cent reporting feeling a mild vibrating sensation, which caused no distress. Good ease of use was reported, as well as a high level of compliance.

Overall, 39 per cent of the participants taking the capsule had one or more complete bowel movements per week. This is compared to 22 per cent of those taking a similar-looking placebo. Nearly 23 per cent of those taking the active capsule had two or more complete spontaneous bowel movements per week, in comparison with almost 12 per cent of those taking the placebo. 

Co-author Dr Eamonn Quigley, head of gastroenterology and Director of the Lynda K and David M Underwood Centre for Digestive Disorders at Houston Methodist Hospital, commented: “The vibrating capsule is a novel non-pharmacological approach to the management of chronic constipation, a common and challenging problem worldwide. These results demonstrate the safety and efficacy of the vibrating capsule in the management of chronic constipation.”

Co-author Dr Satish SC Rao added: “It’s the first of its kind in the entire GI world. First of all, it’s a device, it is not a drug. It’s a non-pharmacological treatment, and secondly, it works right in the colon, the target area, where it’s exciting the muscles in the wall of the colon to do their job.”

As you might expect, there was some concern that the capsule’s effects may flush-out important gut microbiome but, thankfully, the team found no evidence that they were ‘throwing the baby out with the bath water’. It’s a potentially important development in a condition that makes countless millions of people miserable.

If you want to drill deeper into the results, this fascinating study was published recently in Gastroenterology.

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