Auricular Neurostimulation
What is auricular neurostimulation?
Auricular neurostimulation is a non-surgical, non-drug treatment that uses gentle electrical signals on the outer ear to help calm stomach pain and nausea. At Nationwide Children’s Hospital, it is offered through our Neurogastroenterology and Motility Disorders Center for children with certain disorders of gut-brain interaction, sometimes called functional abdominal pain disorders.
A very small device sits behind the ear, with thin leads that attach to the skin. These leads stimulate tiny branches of nerves that help carry messages between the gut and the brain. By changing how these nerves fire, auricular neurostimulation can reduce pain signals and improve how the brain and gut communicate. Devices in this category, such as IB-Stim, are FDA cleared for adolescents with abdominal pain and nausea caused by irritable bowel syndrome (IBS) or functional dyspepsia.
What does auricular neurostimulation treat?
Auricular neurostimulation is used for certain children who have ongoing abdominal symptoms even after standard treatments have been tried. These may include:
- Functional abdominal pain disorders, including IBS
- Chronic or frequent stomach pain not linked to an injury or infection
- Nausea that is related to disorders of gut-brain interaction
These conditions do not mean the symptoms are “in your child’s head.” Instead, the nerves and pathways between the brain and gut are extra sensitive. Auricular neurostimulation helps “turn down the volume” on pain and nausea signals. Studies in children and teens show that this type of therapy can lessen abdominal pain, nausea, anxiety and disability related to these disorders.
Your child’s motility disorders specialist will decide if auricular neurostimulation is appropriate based on age, diagnosis, past treatments and overall health. It is usually used along with other care, such as medicines, nutritional support and behavioral therapy.
What happens before treatment?
Before starting, your child will have a detailed visit in our Neurogastroenterology and Motility Disorders Center. The team will:
- Review your child’s medical history, test results and current medicines
- Confirm the diagnosis and talk about all treatment options
- Explain how auricular neurostimulation works, including benefits and risks
You will have time to ask questions and discuss your goals for treatment. Our team may use simple pain and symptom scales so your child can rate pain and nausea before therapy begins. This helps us track improvement over time.
Insurance approval is often required. Our staff will work with your family and your insurer to check coverage and outline any out-of-pocket costs.
What happens during auricular neurostimulation?
Auricular neurostimulation is done in the clinic and does not require sedation. Your child stays awake the entire time. A provider will:
- Clean the skin around the ear
- Place a small device behind the ear
- Attach thin leads that rest on or just under the top layer of skin
Most children feel only brief pressure when the device is placed. Some feel a mild tingling or pulsing sensation that usually fades quickly. Once the device is on, your child can go home and return to most normal activities. You will receive specific directions about sports, bathing and device care.
Treatment is usually given over several weeks. Devices are worn for 5 days, then removed, and a new device is placed weekly for a set number of weeks. Your child’s care team will explain the exact schedule.
What happens after treatment?
While the device is in place, you will watch for skin redness, tenderness or irritation around the ear. Mild soreness is common and usually improves.
Over the weeks of treatment, many children notice gradual improvement in abdominal pain, nausea, sleep and daily functioning. Your child’s provider may repeat symptom scales or questionnaires to measure change.
After the treatment series is complete, the team will decide on next steps. Some children continue to feel better for weeks or months. Others may need additional therapies, such as medicine adjustments, nutrition changes, physical therapy or behavioral health support.
Why Nationwide Children’s Hospital?
At Nationwide Children’s, auricular neurostimulation is offered through our Neurogastroenterology and Motility Disorders Center, a high-volume pediatric motility program that understands growing bodies and complex gut-brain conditions. Families travel from across the country and around the world for our expertise in pediatric gastrointestinal motility and disorders of gut-brain interaction.
Your child’s care is coordinated by a dedicated team — pediatric GI, pain and psychology, nursing, nutrition and social work — using advanced diagnostics and a full range of neurostimulation and medical therapies. We pair child-sized equipment with pediatric-trained staff and careful monitoring to maximize comfort and safety. Whenever possible, we streamline clinic visits, testing and procedures so your child’s evaluation and recovery move efficiently. Above all, our goal is not only to reduce pain and nausea today, but also to address the underlying brain-gut pathways so your child can return to school, activities and everyday life.
What Happens During Anorectal Manometry?
During the test, your child lies on their side on a bed and parents are present. A small, soft tube (catheter) with a tiny balloon at the tip is gently placed into the rectum using lubricating gel. The tube is connected to a computer. As the balloon is slowly filled with air, the computer measures how the muscles squeeze and relax. Your child may be asked what sensations they feel, to squeeze like they are “holding in poop,” or to push like they are trying to have a bowel movement. They will sit on a bedside commode and try to pass a bowel movement. Most children say the test feels strange but is not painful. There is no cutting or surgery involved, and most children can go home and return to normal activities right after the test.
In infants, a modified version of this test can be done to evaluate for Hirschsprung disease and if inconclusive, a rectal biopsy can be performed in the same encounter.
In some children, a version of this test is performed under anesthesia.
What Does 3-D Capability Mean?
At Nationwide Children’s, our high-resolution anorectal manometry has advanced 3-D capability. This means the tube has many tiny sensors all around it and along its length. These sensors pick up pressure from every side of the anal canal and rectum at the same time. The computer then turns those readings into a highly detailed three-dimensional “map” of pressure, shown in color on the screen.
With 3-D manometry, our providers can see not only how strong the muscles are, but exactly where they may be weak, tight, or not working together. It gives a more complete picture than standard manometry, which uses fewer sensors. For children with complex motility or colorectal problems, this level of detail can make a real difference in diagnosis and treatment planning. But it is not the right test for every patient.
How Does This Test Help my Child?
Information from high-resolution anorectal manometry can help your child’s team:
- Confirm or rule out certain conditions that affect the rectum and anus.
- Decide whether surgery is needed or if previous surgery is working as it should.
- Adjust medicines, bowel management plans, or other therapies.
- Plan biofeedback or physical therapy that teach children how to better use their pelvic floor muscles.
Because the test is done in a center that cares only for children and teens, every step is designed with their comfort and safety in mind.
Why Choose Nationwide Children’s?
Families travel from across the country and around the world to seek care at Nationwide Children’s Neurogastroenterology and Motility Disorders Center. Our program is recognized as a leader in pediatric gastrointestinal care and advanced motility testing, and the hospital is nationally ranked for gastroenterology and GI surgery. Your child’s care team may include pediatric gastroenterologists, colorectal and pelvic reconstruction surgeons, nurse practitioners, psychologists, dietitians, and child life specialists working together on a personalized plan. We use the latest technology, like 3-D anorectal manometry, along with research-driven treatments to provide clear answers and practical solutions. At Nationwide Children’s, we focus not only on test results, but on helping your child get back to school, friends, and the activities they enjoy.
Medical Reviewer: Peter Lu, MD, Nationwide Children's Hospital
Date Last Reviewed: 2/13/2026
The information provided here is only for general reference and should not take the place of medical care or patient education. If you have any questions, please contact your care team.
