IB-Stim (Neuro-Stim) for Adolescents with Irritable Bowel

A recent study (A Krasaelap et al. Clin Gastroenterol Hepatol 2020; 18: 1987-1994.  Efficacy of Auricular Neurostimulation in Adolescents With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial) with data from a double-blind trial provides evidence of short-term (4 week) efficacy of auricular neurostimulation therapy (aka. IB-Stim or Neuro-Stim).

Key findings:

  • The IB-Stim group (n=27, median age 15 years) had a ≥30% reduction in abdominal pain in 59% compared to 26% of the sham group (n=23)
  • A symptom response scale score of 2 or more was observed in 82% of patients who received IB-Stim vs 26% of patients in the sham group ( P ≤ .001)

Discussion points:

  • The authors indicate that the NNT for IB-Stim is 3 compared to 6-14 for other medical therapies (lubiprostone, linaclotide, and rifaximin)
  • The effects of IB-Stim were NOT sustained at follow-up 8-12 weeks and there was no significant improvment in functional disability or anxiety.  “The lack of long-term effect…likely reflects insufficient statistical power.”  The authors indicate that longer or repeated courses could be needed

My take: This study indicates that IB-Stim can be helpful, at least in the short term, for adolescents with IBS.  More studies showing long-term benefit would be helpful.

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