Effects of Transcutaneous Electrical Acustimulation on Refractory Gastroesophageal Reflux Disease

Abstract

Objective. To investigate effects and possible mechanisms of transcutaneous electrical acustimulation (TEA) performed by a wearable watch-size stimulator for refractory gastroesophageal reflux disease (RGERD). Methods. Twenty patients diagnosed as RGERD were enrolled in the study and randomly divided into four groups: esomeprazole group (Group A), esomeprazole combined with TEA group (Group B), esomeprazole combined with sham-TEA group (Group C), and esomeprazole combined with domperidone group (Group D). HRM and 24 h pH-impedance monitoring and GerdQ score were used to measure related indexes before and after treatment. Results. (1) TEA significantly increased LESP, compared with PPI treatment only or PPI plus sham-TEA. After pairwise comparison, LESP of Group B was increased more than Group A (P = 0.008) or Group C (P = 0.021). (2) PPI plus TEA decreased not only the number of acid reflux episodes but also the number of weak acid reflux episodes (P = 0.005). (3) Heartburn and reflux symptoms were improved more with PPI + TEA than with PPI treatment only or PPI plus sham-TEA (GerdQ scores, P = 0.001). Conclusion. TEA can improve symptoms in RGERD patients by increasing LESP and decreasing events of weak acid reflux and acid reflux; addition of TEA to esomeprazole significantly enhances the effect of TEA.

Figure 1

The wearable watch-size stimulator.

Figure 2

Low esophageal pressure before and after the treatment in different groups. A significant increase was noted only in patients treated with TEA (^∗ P = 0.004).

Figure 3

The acid reflux episodes of all the groups decreased after treatment (^∗ P < 0.05). The change of the acid reflux episodes was not significantly different among groups (P > 0.05).

Figure 4

The weak acid reflux episodes of Group B and Group D decreased after treatment (^∗ P < 0.05).

Figure 5

The GERDQ scores of all the groups decreased after treatment (^∗ P < 0.05).