McClurg D, Booth L, Herrero‑Fresneda I.

Safety and Efficacy of Intermittent Colonic Exoperistalsis Device to Treat Chronic Constipation: A Prospective Multicentric Clinical Trial
Clinical and Translational Gastroenterology, 2020
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Study design
Prospective multicentre clinical trial (n = 92) in adult patients with chronic constipation of neurogenic and idiopathic origin with high component of pelvic floor disorders.

Summary
Daily use over 4 weeks demonstrated statistically significant improvements in complete bowel movements per week, constipation symptoms (KESS), and quality of life (PAC‑QoL). Treatment adherence was ≥95%, ) with a high number of responders (72,2% for bowel movements; 77,4% for constipation symptoms; 81% for Quality of life). Adverse events were infrequent and predominantly mild to moderate.

Conclusion
The results support the safety, feasibility, and clinical benefit of ICE therapy in chronic constipation of idiopathic and neurogenic origin, including pelvic floor disorders.

Bremer J, Bremer J, König M, Koßmehl P, Kurze I, Obereisenbuchner J, Weinschenk E, Herrero Fresneda I.

ICE for Chronic Constipation in SCI Individuals – Long‑term Structured Patient Feedback Survey
Spinal Cord Series and Cases, 2023
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Study design
Multicentre long‑term in‑home evaluation (n = 11), mean treatment duration ~13 months.

Summary
Long‑term use resulted in reduced evacuation time and symptom burden, including abdominal pain, bloating, and strain. Improvements were also observed in incomplete evacuation and patient satisfaction, with stable use of adjunctive treatments. Patients reported reported tolerability, efficacy, and ease of use as very good/good.

Conclusion
Findings indicate that ICE therapy supports long‑term bowel management in patients with neurogenic bowel dysfunction.

Delgado M, Benet J, Herrero Fresneda I.

Safety and Efficacy of Manual and Automated Abdominal Colonic Massage for Chronic Constipation: A Systematic Review and Meta‑analysis
Clinical and Translational Gastroenterology, 2026
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Study design
PRISMA‑compliant systematic review and meta‑analysis (54 studies, n≈1,965) evaluating manual and automated abdominal colonic massage, with automated approaches largely represented by the MOWOOT device, across patients with functional or chronic idiopathic constipation (FC/CIC) and neurogenic bowel dysfunction (NBD).

Summary
Manual and device‑assisted abdominal massage approaches demonstrated improvements in bowel function and quality of life, with a favourable safety profile across studies.

Conclusion
The findings support abdominal colonic stimulation as an effective therapeutic approach in patients with FC/CIC and NBD, with device‑based solutions providing a standardised and reproducible alternative.

Pilot and observational studies

Finlayson J, Goodman K, Crocket J, Sharma S, Kelly J, Sellers C, Hagen S.

Abdominal Massage for Adults with Intellectual Disability and Constipation: A Feasibility Pilot Study
Journal of Applied Research in Intellectual Disabilities, 2026
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Study design
Feasibility pilot study (n = 31) in adults with intellectual disability in community care.

Summary
The study demonstrated feasibility and acceptability of abdominal stimulation in a patient segment with high constipation prevalence, complex care needs, and limited suitability for many existing interventions. A majority of participants and caregivers (79%) preferred a device‑based approach with the MOWOOT system, highlighting advantages in consistency and ease of use.

Conclusion
Abdominal stimulation is feasible in this population; further studies are required to confirm effectiveness.

Herrero‑Fresneda I, McClurg D.

People chronically taking constipation-inducing medication benefit from daily use at home of the ICE medical device
Gut / IDDF, 2024

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Study design
Subgroup analysis (n = 42) from a prospective multicentre clinical trial.

Summary
ICE therapy demonstrated improvements in bowel movement frequency, constipation symptoms, and quality of life following 4 weeks of daily home use.

Conclusion
Results support ICE therapy as a non‑pharmacological treatment option in medication‑induced constipation.

Herrero‑Fresneda I, McClurg D.

Effect of Intermittent Colonic Exoperistalsis on people taking contipation-inducing medicacion. Medical device use at home without patient supervision.
United European Gastroenterology Journal, 2024

Study design
Prospective evaluation in patients with constipation‑inducing medication.

Summary
ICE therapy increased bowel movements and improved symptoms and quality of life in patients treated at home without supervision.

Conclusion
Findings support safe and effective use of ICE therapy for managing medication-induced constipation in home settings.

Herrero‑Fresneda I et al.

Intermittent Colonic Exoperistalsis Reduced Suppositories and Oral Laxatives in Functionally Constipated Women With Slow Transit.
American Journal of Gastroenterology / UEG Week, 2023

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Study design
Real‑world observational study (n = 12) in patients with slow‑transit constipation.

Summary
Long‑term use resulted in improved bowel function and reduction in laxatives, suppositories, and enemas in a proportion of patients.

Conclusion
ICE therapy supports optimisation of bowel management strategies in selected patients with slow-transit constipation.

Herrero‑Fresneda I et al.

Intermittent colonic exoperistalsis treatment of chronic constipation in spinal cord injured patients. Evaluation of the MOWOOT device in home care use.
Gut, 2022

Study design
Observational structured feedback study (n = 28).

Summary
Patients reported increased bowel movements, reduced evacuation time, and improved symptoms, with high levels of usability and tolerability during home use.

Conclusion
Results support the clinical utility of ICE therapy in long‑term outpatient care for patients with neurogenic bowel dysfunction.

Herrero‑Fresneda IH et al.

Compassionate Use of an Intermittent Colonic Exo-Peristalsis Device for a Handicapped Minor to Treat Chronic Constipation)
American Journal of Gastroenterology, 2022

Study design
Case study (n = 1) in a paediatric patient multiple disabilities and severe constipation.

Summary
ICE therapy improved bowel function and reduced laxative use, with high patient satisfaction and good tolerability.

Conclusion
Findings demonstrate the benefit of ICE therapy in routine outpatient use for patients with functional constipation.

Herrero‑Fresneda IH et al.

Home Care In-Use Evaluation of ICE Device to Treat Chronic Functional Constipation in the General Population.
American Journal of Gastroenterology, 2022

Study design
Observational study (n = 18) in patients with chronic functional constipation.

Summary
ICE therapy improved bowel function and reduced laxative use, with high patient satisfaction and good tolerability.

Conclusion
Findings demonstrate the benefit of ICE therapy in routine outpatient use for patients with functional constipation.

Herrero‑Fresneda I

ICE Device for the Treatment of Chronic Constipation in SCI Patients.  A long-term evaluation in Home Care use.
UEG Week, 2021

Study design
Long‑term evaluation (n = 47) in patients with neurogenic bowel dysfunction due to spinal cord injury (SCI).

Summary
ICE therapy increased bowel movement frequency, reduced evacuation time and symptom burden, and decreased use of bowel management interventions in a proportion of patients.

Conclusion
Long‑term ICE use demonstrates sustained benefits in bowel management and high tolerability in patients with neurogenic bowel dysfunction due to spinal cord injury.

Romero G, Jané C, Herrero‑Fresneda I, Falguera N.

Efectividad de la Exo-Peristalsis Intermitente de Colon con MOWOOT como tratamiento del estreñimiento crónico
SERMEF Congress, 2020

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Study design
Prospective clinical study (n = 33) in female patients (age 50-90) with chronic idiopathic constipation.

Summary
After 15 consecutive days of treatment, patients experienced increased bowel movement frequency, improved stool consistency, reduced time spent evacuating, and reported a pleasant treatment experience.

Conclusion
MOWOOT effectively relieved chronic constipation symptoms in older women, supporting its use as a safe, non-pharmacological, home-based treatment to improve bowel function and patient well-being.

Herrero‑Fresneda I

Empowering Chronically Constipated Spinal Cord Injured patients by allowing them to take control over their bowel management.
IHF World Hospital Congress, 2020

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Study design
Long‑term evaluation (n = 47) in patients with neurogenic and idiopathic constipation.

Summary
ICE therapy increased bowel movement frequency, reduced evacuation time and symptom burden, and decreased use of bowel management interventions in a proportion of patients.

Conclusion
Long‑term ICE use demonstrates sustained benefits in bowel management and high tolerability in patients with neurogenic bowel dysfunction due to spinal cord injury.

Herrero‑Fresneda I, Klamburg J, Benet M, Calzada A, Wilhelms M.

Benefits of automated massage with MOWOOT on chronic constipation
Journal of Gastrointestinal & Digestive System, 2018

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Study design
Pilot study (n = 8) in adults with chronic constipation.

Summary
Patients experienced significant improvements in bowel movement frequency, stool consistency, defecation time, and overall constipation severity. No adverse events were reported, and participants described the treatment as comfortable and relaxing.

Conclusion
MOWOOT significantly improved key constipation outcomes, increasing bowel frequency, improving stool consistency, and reducing evacuation time, supporting the potential of automated abdominal massage as a safe and effective non-pharmacological treatment for chronic constipation.

Herrero‑Fresneda I, Benet M, Calzada A, Wilhelms M.

Colon-specific automatic massage ameliorates idiopathic chronic constipation in aged women.
European Geriatric Medicine, 2016

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Study design
Pilot study (n=10) in elderly women with chronic constipation.

Summary
Treatment improved bowel movement frequency, stool consistency, and evacuation time, with good tolerability and no reported adverse events.

Conclusion
Results support the effectiveness of automated colonic massage in chronic constipation.