A method of stimulating the nerves and muscles around the colon and sphincter may be effective in treating congenitally refractory constipation that has not been treated conservatively with medications, potentially allowing patients to be spared a colectomy. This approach is known as sacral nerve stimulation therapy. In a prospective European multicenter trial, 65 patients suffering from sluggish bowel movement constipation or impaired bowel movement normal peristaltic constipation failed with relaxation or behavioral therapy. The patients’ symptoms included having two or fewer bowel movements per week, straining to defecate 50% of the time, and a feeling of incomplete defecation more than 25% of the time after defecation. Sacral nerve stimulation is a minimally invasive method that is performed through an implanted instrument. It consists of a tiny insulated metal wire, a nerve stimulator much like a pacemaker. This instrument is about the size of a pocket stopwatch and is inserted under the skin of the patient’s upper buttocks. The thin metal wire delivers a constant low current stimulus to the sacral nerve that supports the large intestine and sphincter. In the first part of Dr. Dudding’s study, this apparatus was tested temporarily in all study participants and bowel habits were recorded over a 21-day period. As a result, 43 of 65 patients (65%) demonstrated a 50% improvement in symptoms, meeting the requirement for permanent implant treatment. Subsequently, after an average follow-up of 12 months, the number of bowel movements almost doubled in these 43 patients, from 3.4 to 6.1 per week. In addition, the number of days of bowel movements per week increased from 2.4 to 4.4, the time spent on the toilet decreased from 17.6 to 9.3 minutes, straining to defecate decreased from 4.4 to 2.9 times per week, abdominal pain decreased from 4.4 to 2 days per week, and the sensation of incomplete defecation decreased. All results were statistically significant except for straining to defecate. In addition, the patient’s Clinfran clinical constipation score (0 for no constipation and 30 for severe constipation) was significantly reduced from 18 to 10.2. Patients’ quality of life scores for physical function, general health, vitality, social function and mental health also improved significantly when surveyed using a simple 36-item questionnaire.