Good vibes only: Vibrations against constipation

Chronic constipation patients are dissatisfied with QoL and conventional intervention results. But there's a new treatment concept: a vibrating capsule.

Key issues to know about the vibrating capsule:

• The capsule was tested on patients suffering from chronic constipation in a randomised phase III study.
• Study participants received either the vibrating capsule or a placebo.
• The patient activated the vibration at a set time.
• The study showed statistically significant improvements in stool frequency, pressing during bowel movements, stool consistency and quality of life.
• FDA approval is expected by the end of the year.

Vibrations help physiological peristalsis

Conventional therapies for constipation aim to improve bowel motility or secretion. But many sufferers do not achieve the desired success with these treatment options. In addition, there are possible side effects of pharmacological therapy. 

Experts in the field of intestinal peristalsis and constipation have therefore conducted a multicentre, randomised phase III study in which they investigated the effect of the vibrating capsule. This effect is said to be achieved by stimulating the intestinal peristalsis and the body's own intrinsic biorhythm. Thus, it could represent a non-drug treatment for chronic constipation.

Capsule activation at set times

Operation and handling of the product are simple - patients swallow the capsule in the evening and activate the vibrations externally the next day. In the study, the vibrating capsule was taken five days a week over a period of eight weeks. Activation was either at 2pm or 6am - with the afternoon schedule giving slightly better results.

The shock waves last three seconds and are followed by a 16-second pause. This rhythm takes place over two hours. The capsule is then excreted with the stool.

Significant improvements, without side effects

Compared to the placebo group, statistically significant improvements were achieved for the study participants in the capsule arm:

• The probability of one or two more targeted bowel movements per week was significantly higher for those taking the vibration capsule than for those taking the placebo capsule.
• Those affected had to push less to empty their bowels.
• Stool consistency was improved.
• The quality of life was improved.

The researchers assume that the good efficacy is associated with the imitation and support of the natural body rhythm. They also emphasise that there were no increased side effects during treatment with the vibration capsule - on the contrary: the therapy was well tolerated. However, about 11 % of the study participants reported being able to feel the shock waves.

Implications for clinical practice

The new vibrating capsule could be an attractive treatment option for people with chronic constipation. Although the therapy was well tolerated in the study, taking a capsule is not suitable for all patients - especially those who have already had bowel surgery or have narrowing of the lumen should avoid taking it. FDA approval is expected for the end of 2022; when and whether this will also happen for Germany remains to be seen.