Clinical Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) in Pediatric Functional Constipation: Impact on Immunological Indicators and Gut Microbiota.

Objective: This study was conducted to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in treating pediatric functional constipation (FC) and to explore its mechanisms by analyzing changes in serum neurotransmitters and gut microbiota. Materials and Methods: This was a prospective cohort study conducted on 60 children aged 4-14 years diagnosed with FC. Participants were divided into two groups, namely, one receiving TENS therapy three times a week for 4 weeks and the control group receiving lactulose. Pretreatment and posttreatment evaluations included serum neurotransmitters, immunological indicators, and gut microbiota composition. Results: The TENS group demonstrated significant improvements in defecation frequency and constipation symptoms compared with the lactulose group (p < 0.001). Posttreatment, remarkable increases were detected in serum motilin and vasoactive intestinal peptide (VIP) levels, along with a significant decrease in interleukin-12 levels (p < 0.05), indicating anti-inflammatory effects. Gut microbiota analysis revealed significant shifts in microbial composition, with an increase in the abundance of Bacteroidetes and a decrease in the abundance of Firmicutes/Bacteroidetes ratio, suggesting improved gut health and metabolic function. Conclusion: TENS effectively improves symptoms of pediatric FC and induces beneficial changes in immunological indicators and gut microbiota. These results suggest potential anti-inflammatory and microbiota-modulating effects. However, due to the limited sample size, further studies are needed to confirm these findings and explore the long-term benefits of TENS therapy. Trial Registration: Clinical Trial Registry identifier: ChiCTR2200059549.