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Review
. 2015 Apr;18(3):221-7; discussion 227.
doi: 10.1111/ner.12260. Epub 2015 Jan 12.

Neurostimulation of the gastrointestinal tract: review of recent developments

Thomas L Abell  1 , Jiande Chen, Anton Emmanuel, Christopher Jolley, Abeezar I Sarela, Hans Törnblom
Affiliations
Review

Neurostimulation of the gastrointestinal tract: review of recent developments

Thomas L Abell et al. Neuromodulation. 2015 Apr.

Abstract

Objective: Neurostimulation is one manifestation of neuromodulation of the gastrointestinal (GI) tract. This manuscript reviews the history of neurostimulation of the GI tract with emphasis on current methods of stimulation.

Materials and methods: A review was completed of the current research on GI neurostimulation methods with an emphasis on their clinical applications.

Results: Upper GI disorders can be modulated with both temporary (placed endoscopically or surgically) or permanent (placed surgically) gastric electrical stimulation (GES) devices. The current GI neurostimulation of stomach (GES) devices have been used in both children and adults, and some patients have been followed in excess of 15 years with good long-term results. Similar GES devices also have been used for a variety of lower GI disorders, including constipation and fecal incontinence, for a number of years.

Conclusions: GI neurostimulation, as a type of neuromodulation, has been demonstrated to function at several locations in the GI tract for a variety of disorders. The future of neurostimulation in the GI tract will likely be influenced by a better understanding of pathophysiology as well as the development of new techniques and devices for neuromodulation.

Keywords: Gastric electrical stimulation; gastroparesis; nausea and vomiting; neuromodulation.

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Conflict of interest statement

Relevant Conflict of Interest Disclosures:

Dr. Abell is a consultant, licensor and investigator for Medtronic. Some of the techniques of neurostimulation discussed are part of IP from the University of MS, now assigned to ADEPT-GI.

Figures

Figure 1
Figure 1
The effect of temporary endoscopic GES on vomiting from 58 patients in randomized double-masked crossover trial. (Adapted from reference #.)
Figure 2
Figure 2
The mean and median values for nausea in the same group as Figure 1.
Figure 3
Figure 3
The effect of temporary endoscopic GES on Total GI Symptom score. (Adapted from reference #.)
Figure 4
Figure 4
Comparison of total symptom score of responders vs. non-responders of temporary endoscopic GES in pediatric patients.
Figure 5
Figure 5
Temporary GES electrodes inserted through the abdominal wall and connected to an external Enterra® device before being covered by protective adhesives.
Figure 6
Figure 6
Study flow-chart showing a response rate for blinded TPGES comparing the on and off periods (not baseline symptoms) at 41%.
See this image and copyright information in PMC

References

    1. Dieffenbach WH. Electric treatment of intestinal obstruction and postoperative paralysis of the bowel. JAMA. 1911;LVI(13):958–959.
    1. Alvarez W. The electrogastrogram and what it shows. JAMA. 1922;78(15):1116–1119.
    1. Soffer E, Abell T, Lin Z, et al. Review article: gastric electrical stimulation for gastroparesis--physiological foundations, technical aspects and clinical implications. Aliment Pharmacol Ther. 2009 Oct;30(7):681–694. - PMC - PubMed
    1. Familoni BO, Abell TL, Voeller G, Salem A, Gaber O. Electrical stimulation at a frequency higher than basal rate in human stomach. Dig Dis Sci. 1997 May;42(5):885–891. - PubMed
    1. McCallum RW, Chen JD, Lin Z, Schirmer BD, Williams RD, Ross RA. Gastric pacing improves emptying and symptoms in patients with gastroparesis. Gastroenterology. 1998 Mar;114(3):456–461. - PubMed

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