DDW 2012 Note: Magnetic Stimulation – A Future Treatment for IBS Pain?

Heightened sensitivity to pain in the intestines is a well-established characteristic of irritable bowel syndrome. It has been demonstrated in numerous laboratory studies (typically by inflating balloons inside the intestines up to different pressures) that less intense stimuli are needed to cause individuals with IBS to feel pain compared to healthy people. Although not all IBS patients show this heightened intestinal pain sensitivity, the majority of them are typically found to have it, and it is thought to be one of the major reasons for the abdominal pain that causes so much suffering in IBS. It therefore seems logical that treatments that can reduce this intestinal pain sensitivity would be effective treatments for IBS pain symptoms. The problem is that currently there are hardly any medications or other treatment approaches known that do this reliably.

Yesterday, Monday May 21, Dr. Tarig Algladi presented an intriguing study at Digestive Disease Week 2012 in San Diego,  investigating the use of powerful magnetic force to reduce intestinal pain sensitivity. The treatment is delivered with a special device held against the surface of the body, allowing the magnetic field to  penetrate an inch or two into the body in a tightly targeted way. The magnetic field stimulates nerves and makes them less likely to produce pain signals (this method has been used for other pain problems such as phantom limb pain). In this study, testing the treatment on 10 adult IBS patients, magnetic pulses were delivered hundreds of times in each intervention, and the magnetic stimulation was tried in two different places on the patients’ body – either in a particular spot on the head, stimulating nerve cells in the brain, or on the lowest part of the spine.  The patients’ pain sensitivity was measured inside the rectum before each treatment session, immediately after the session, and again 30 and 60 minutes later. The investigators found that both magnetic stimulation applied on the head and the spine significantly reduced pain sensitivity measured in the rectum and that effect increased over the hour following treatment sessions. They also tested false or “sham” stimulation that did not deliver any magnetic force, and found that unlike the real magnetic stimulation this did not reduce pain sensitivity – confirming that the pain sensitivity reduction seen from the magnetic treatment was not simply due to the subject’s expectation (in other words, not a placebo effect).

This study suggests that magnetic nerve stimulation may be a way to reduce the heightened intestinal sensitivity of IBS patients, and could therefore perhaps be used to treat IBS pain. It is an appealing possibility because the treatment is simple, easy to use and non-invasive (the magnetic devices are simply held over a surface of the body). However, much remains to be investigated before it becomes clear whether this really is a viable IBS therapy. For one thing, it is unclear how long the reduction in pain sensitivity lasts, and how well it will translate into actual reduced clinical pain. Also, it may be risky to apply such treatment repeatedly to a person’s head, as it might have other brain consequences (Dr. Algladi stated that in his opinion, stimulating the spine was likely to be more practical in future implementation of this therapy for that reason). However, it will be very interesting to follow further testing of this novel potential IBS treatment option in the coming years.

Presentation:

 “Evidence for Alteration in Anorectal Sensation to Non-Invasive Repetitive Lumbosacral and Cortical Magnetic Stimulation in Patients With IBS”. Tarig Algladi1,2, Mary Louise Harris1,2, Peter J. Whorwell1, Basma Issa1, Peter Paine2, Shaheen Hamdy1,2. 1The University of Manchester, Manchester, United Kingdom; 2Salford Royal Hospital, Manchester, United Kingdom

Presented at Digestive Disease Week in San Diego on Monday May 21, 2012.

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