P2959 - Clinical Safety and Efficacy of Vibrating Capsules in Treating Chronic Constipation - A Meta-Analysis

Aryan Gupta, ¹, Vinay Chandramouli Bellur, ², Ananya Prasad, ³, Omar Oudit, DO⁴, Vibhav MS, ¹, Vardhini Ganesh Iyer, ⁵, Shekhar Kalra, ⁶, Era Gupta, ⁷, Kushal Prasad, ⁷
1bangalore medical college and research institute, Bangalore, Karnataka, India; 2Ramaiah medical college, Bangalore, Karnataka, India; 3ramaiah medical college, Bangalore, Karnataka, India; 4Brookdale University Hospital Medical Center, Brooklyn, NY; 5BGS Global Institute of Medical Sciences, Bangalore, Karnataka, India; 6Maulana Azad Medical College, Bangalore, Karnataka, India; 7Bangalore Medical College and Research Institute, Bangalore, Karnataka, India

Introduction: Chronic constipation is a prevalent gastrointestinal disorder, significantly impacting patients' quality of life. Traditional treatments often yield suboptimal results, prompting the exploration of innovative approaches. Vibrating capsules have emerged as a novel, non-pharmacological intervention for managing chronic constipation. These devices enhance colonic motility and facilitate bowel movements, especially in cases of chronic idiopathic constipation (CIC). The capsules' vibrations are designed to activate stretch receptors in the intestinal wall, potentially triggering peristalsis and accelerating transit time.

Methods: The review conducted follows the PRISMA guidelines and major medical databases, which include PUBMED, Google Scholar and Science-Direct, were extensively searched using a comprehensive search term to identify and retrieve available articles. The articles which included assessment of bowel functions following vibrating capsule therapy for constipation were included in the analysis conducted.

The mean change in CSBM was considered as the primary outcome to assess the clinical efficacy of Vibratory therapy. Secondary outcomes included comparison of risk of adverse events and odds ratio increase CSBM of at least 1 per week . The data was analysed using the Meta, Metadata and the Metafor packages of R Studio. The Mantel-Haenszel method and the Inverse variance method were utilised to analyse the odds ratio and risk ratio. The I^2 test was used to assess the heterogeneity of the studies.

Results: This meta-analysis included 6 studies comprising of 501 tests subject to vibrating capsules and 405 underwent sham/placebo treatment. The mean change in complete spontaneous bowel movements was statistically insignificant in both groups, indicating similar efficacy.(0.15(-0.22 ;0.53) , I^2 = 62% , p = 0.048). The risk of adverse events(RR =1.31(1.02;1.59), p = 0.0483, I^2 = 34.6%) and diarrheal episodes(RR = 0.56 (0.16 ;1.15), p = 0.49 )did not change significantly between the 2 groups, indicating a similar safety profile. The increase in CSBM of at least 1 per week was marginally higher in the interventional group in comparison to the placebo group. (OR = 1.63(0.85 ; 3.13) , p = 0.01 , I^2 = 71.8%)

Discussion: This review has affirmatively established that the utility of using vibrating capsules in treating chronic constipation is ineffective as compared to sham/placebo capsules. Further research in this domain is required for clinical acceptance.


Figure: The Risk Ratio of Occurrence of of Diarrhoeal episodes, as well as Odds Ratio of CSBM at 1 week between Vibratory therapy vs Placebo


Figure: The Risk Ratio of Adverse Effects, as well as Mean Difference in change of CSBM following Vibratory therapy vs Placebo

Disclosures:
Aryan Gupta indicated no relevant financial relationships.
Vinay Chandramouli Bellur indicated no relevant financial relationships.
Ananya Prasad indicated no relevant financial relationships.
Omar Oudit indicated no relevant financial relationships.
Vibhav MS indicated no relevant financial relationships.
Vardhini Ganesh Iyer indicated no relevant financial relationships.
Shekhar Kalra indicated no relevant financial relationships.
Era Gupta indicated no relevant financial relationships.
Kushal Prasad indicated no relevant financial relationships.

Aryan Gupta, ¹, Vinay Chandramouli Bellur, ², Ananya Prasad, ³, Omar Oudit, DO⁴, Vibhav MS, ¹, Vardhini Ganesh Iyer, ⁵, Shekhar Kalra, ⁶, Era Gupta, ⁷, Kushal Prasad, ⁷. P2959 - Clinical Safety and Efficacy of Vibrating Capsules in Treating Chronic Constipation - A Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.