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Sacral nerve stimulation for intractable constipation: was it really an intractable constipation?
  1. Luigi Benini,
  2. Armando Gabbrielli,
  3. Flora Agugiaro,
  4. Pietro Campagnola,
  5. Italo Vantini
  1. Department of Medicine, University of Verona, Italy
  1. Correspondence to Professor Luigi Benini, Gastroenterology Unit, Policlinico G B Rossi, Piazzale Scuro 10, Verona 37134, Italy; luigi.benini{at}

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We read with interest the paper by Kamm and coworkers on the effect of sacral stimulation on intractable constipation.1 The paper reports the results of an open multicentre study on the effect of this procedure in patients who proved refractory to the standard medical treatments of constipation. We think that some biases limit the application of the study to real-life patients with constipation.

First, the authors correctly report that, in the original paper of the Rome III commission, functional constipation was defined only by the presence of at least two out of five different symptoms.2 A reduced number of bowel movements was simply one of the …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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    Michael A Kamm