IB-STIM

IB-STIM is a small electrical device worn behind the ear that helps reduce abdominal pain in children ages 11 to 18 who have functional abdominal pain related to irritable bowel syndrome (IBS).

IBS is thought to occur because of unbalanced brain-gut signaling resulting in pain and altered bowel habits.

While IBS and other disorders of gut-brain interaction (DGBI) are among the most common conditions seen by pediatricians and pediatric gastroenterologists, there are currently limited treatments available for children with these functional abdominal pain disorders. Most approved IBS medication targets the bowel rather than central pain pathways.

The Motility and Functional Gastrointestinal Disorders Center at Boston Children’s Hospital has been at the forefront of developing safe, effective therapies for abdominal pain-related functional gastrointestinal disorders. We are proud to be one of the few centers in the country to have experience with IB-STIM technology. Under the direction of Rachel Rosen, MD, MPH; Samuel Nurko, MD, MPH; and Elizabeth Burch, MSN, RN, APRN, CPNP, we have been able to offer this innovative therapy to our patients.

How does IB-STIM work?

The IB-STIM device works as a noninvasive percutaneous (meaning it goes through the skin) electrical nerve field stimulation (PENFS) system. It releases electrical pulses that target the areas of the brain involved in processing pain and helps reduce functional abdominal pain associated with IBS.

Children wear the IB-STIM device for five consecutive days — 120 hours — for up to four consecutive weeks. This allows a gradual, gentle delivery of electrical pulses to nerves below the skin that access the central nervous system. IB-STIM works to decrease the pain signals sent by the gastrointestinal (GI) tract.

The IB-STIM device is placed behind the ear because the outside (external) ear contains branches of cranial nerves that project directly to the brainstem, providing an efficient channel for effective neurostimulation. Our work with IB-STIM shows what auricular (ear) neurostimulation reduces abdominal pain by about 30 percent and improves overall well-being in adolescents with IBS.

Why might my child’s doctor recommend IB-STIM?

A physician may suggest IB-STIM if your child is between 11 and 18, if other IBS medications have failed, and if they believe IB-STIM would work well with other IBS treatments or therapies your child is receiving.

IB-STIM may not be the appropriate treatment for all children with IBS or other types of chronic abdominal pain. Your child’s physician will assess if they are eligible for the procedure.

Are there risks associated with using IB-STIM?

IB-STIM is not recommended for children with pacemakers or children who have hemophilia. There is also a small risk of ear discomfort. IB-STIM is not recommended for children with psoriasis or other skin conditions, as the device uses adhesives to connect the skin behind the ear, which could cause an allergic reaction.