Intermittent colonic exoperistalsis for chronic constipation in spinal cord-injured individuals. A long-term structured patient feedback survey to evaluate home care use

Study design: Structured patient feedback survey evaluating real-world home care use. Objectives: To assess the long-term effectiveness, tolerability, and satisfaction with the intermittent colonic exoperistalsis (ICE) treatment device MOWOOT in spinal cord-injured (SCI) individuals with chronic constipation. Setting: Four specialized German hospitals. Methods: SCI individuals with chronic constipation were invited to use MOWOOT 10–20 minutes daily and answer a questionnaire about their bowel situation before treatment (F1) and after at least 10 months of use (F2). Variables included device use, bowel function effectiveness, constipation symptoms, concomitant use of laxatives and evacuation aids, and satisfaction with bowel function and management; F1–F2 comparisons were performed. At F2, participants also rated efficacy, tolerability/side effects, and ease of use. Results: Eleven participants used the device for a mean (SD) of 13.27 (4.03) months. From F1 to F2, mean time per evacuation decreased by 24.5 minutes (p = 0.0076) and failed evacuation attempts/week decreased by 1.05 (p = 0.0354). There were tendencies toward increased bowel movements, softer stool consistency, and fewer incomplete bowel movements. Participants reported reduced difficulty/strain (p = 0.0055), abdominal pain (p = 0.0230), bloating (p = 0.0010), abdominal cramps (p = 0.0019), and spasms (p = 0.0198), with no significant changes in laxative or evacuation aid use. Satisfaction with bowel function and management improved (p = 0.0095), and more participants were very satisfied/satisfied (p = 0.0300). Most rated tolerability, efficacy, and ease of use as very good/good. Conclusion: Long-term in-home ICE treatment improved bowel function and chronic constipation symptoms in SCI individuals, providing clinical benefits to this population.

Jana Bremer, Jörn Bremer, Maike König, Peter Koßmehl, Ines Kurze, Jeannette Oberiesenbuchner, Elisabeth Weinschenk, Immaculada Herrero-Fresneda