# Transcutaneous Electrical Nerve Stimulation (TENS)



## Moises

A new member named glenn joined on April 19 and made four identical posts in 15 minutes. He wanted to share the good news that he was able to treat his D successfully by using a TENS unit.glenn1glenn2glenn3glenn4That prompted me to notice that there was a copy of a PUBMED abstractin the NewsFeed forum confirming that there is evidence supporting the use of TENS units to treat gut dysmotility. In the abstract, the use of TENS slowed transit time. The authors conclude that TENS might help treat IBS in humans.I actually had TENS treatments many many years ago in a chiropractor's office. At the time I had some kind of pain, probably in my back. I do not remember experiencing any associated digestive improvement at the time. But I probably wasn't paying attention, since I went to the chiro for some kind of acute pain.Given the relative low cost of TENS units, and given that I believe the risk of doing damage is minuscule, I ordered a unit online. It is scheduled to arrive tomorrow. Since very few people read the PUBMED forum, I thought I would create a new thread here where we can discuss the possible benefits and costs of TENS.


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## Moises

Yesterday, Sunday, was my first use of my new TENS unit. My unit automatically shuts off after 15 minutes. I am not sure how many 15-minute sessions I had. But it was at least 4.Today I reread glenn's post and noticed that he said to place the electrode pads above the stomach. To do that would mean to place some pads right under the armpits. I had my pads on the lower part of my ribs on the side and on my back, at a corresponding level. It is too soon to determine if thee is an effect on diarrhea. I currently take 2 loperamide (generic Imodium) daily, one upon arising and one before bed. But I did notice that my severe burping problem seemed to have abated. The effect was striking. The downside was that it did not seem to last too long, and my gut did bother me as around 1:45am when I was trying to sleep.This morning I used it before leaving my apartment to go to work. Again, it seemed to help lessen my burping problem. I decided to wear the unit as I drove to work. It did not affect my driving abilities and it did seem to lessen the amount of burping I normally have when driving to work.These observations are all very provisional, so I am not drawing any conclusions yet. But I went into this with a great deal of skepticism. Right now I am more hopeful than I was 24 hours ago, when I had yet to try it.One problem with this is that there are so many variables:1. Placement. The PUBMED rat study focused on colonic motility. Sometimes the GI literature refers to the "large colon" and "small colon." So, there is s certain ambiguity in the word colon. I usually assume "colon" refers to large intestine. It would seem that if we want to affect the large intestine we should place the electrode pads on the lower abdomen. And in the rat study, they placed the electrodes on the rear legs. My most disturbing symptom is burping, which occurs higher up, so I am trying to follow glenn by placing my pads higher up. It's not clear if it's good to put pads too close to the heart. Mine are near heart level but on the sides and back.2. Timing. The rat paper only used the treatment every other day. The abstract does not say how long they were exposed to the stimulation. I've done this for less than one day. My current view is the more the better. But that is not very practical.3. Intensity. I have been gradually increasing the intensity raising it as high as I can tolerate. I have no idea if there is positive correlation between intensity and response. But that is my initial working assumption.


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## Moises

Here's another abstract:Rectal hypersensitivity reduced by acupoint TENS in patients with diarrhea-predominant irritable bowel syndrome: a pilot studyThis time they are using TENS on human beings.I really wish I had access to the full article.Stool times were decreased in those with D. What it does not say is where the electrical stimulation was applied. The concern was high rectal sensitivity, so I would assume the electrodes were placed lower down than the ribcage location recommended by glenn.


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## Moises

Here's some more relevant research, but I am pretty skeptical about this one:Effect of electroacupuncture on visceral hyperalgesia, serotonin and fos expression in an animal model of irritable bowel syndromeUsing TENS-like stimuli on real acupuncture points on rats more effectively reduced pain than using TENS-like stimuli on sham acupuncture points.If this is true, then placement of the electrodes is very important.


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## Moises

OK, the locations are acupuncture points ST-36 and ST-37.Repeated electro-acupuncture attenuates chronic visceral hypersensitivity and spinal cord NMDA receptor phosphorylation in a rat irritable bowel syndrome modelHere's a video for locating ST-36.


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## Moises

Last night, I used the unit for a couple of hours. I still had my typical problems with burping in the evening and during the night.This morning, I decided to put the pads on my shins. I don't know if I got the acupuncture spots or not. So far today, I do not notice any improvement.


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## Moises

I had the electrodes on my upper shin yesterday. I lowered my Imodium to 1 pill/day because I hadn't had a BM in 2 days. But my burping was pretty bad.Today I am wearing the electrodes at work and placed them about 1 inch below the bottom of the breastbone, but on the side of my ribs and on the back. I am being stimulated as I write this. I think that glenn might have a better placement than the papers that recommended the shins.


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## Moises

This is no cure. But I think that it might be allowing me some incremental improvement. It's too soon to make any categorical judgement. I have moved the electrodes to the front of the body on the lower edge of the ribs. I will continue to play with their location.


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## Moises

This youtube video says to put the TENS unit a 3-5 inches below the navel.


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## Moises

I've decided that TENS is a nice way to get a massage, but it hasn't improved my digestion.


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