Electroceuticals for Neurogastroenterology and Motility Disorders

Abstract

Purpose of review: To provide an updated overview on use of electrostimulation in gastrointestinal motility disorders and obesity, with a focus on gastric electrical stimulation, vagal nerve stimulation and sacral nerve stimulation.

Recent findings: Recent studies on gastric electrical stimulation for chronic vomiting showed a decrease in frequency of vomiting, but without significant improvement in quality of life. Percutaneous vagal nerve stimulation shows some promise for both symptoms of gastroparesis and IBS. Sacral nerve stimulation does not appear effective for constipation. Studies of electroceuticals for treatment of obesity have quite varied results with less clinical penetrance of the technology. Results of studies on the efficacy of electroceuticals have been variable depending on pathology but this area remains promising. Improved mechanistic understanding, technology and more controlled trials will be helpful to establish a clearer role for electrostimulation in treatment of various GI disorders.

Keywords: Electrostimulation; Gastroparesis; Sacral nerve stimulation; Vagal nerve stimulation.

Fig. 1

An illustration of the type of electrical stimulation delivered by the Enterra system for gastroparesis. Short bursts of short duration rectangular pulses (330 μsec each) are given at a frequency of 14 Hz in each burst. Bursts last 0.1 s, and are delivered every 5 s. This is the default setting, but variables can be adjusted depending on clinical response. This type of stimulus is referred to as short duration/high frequency stimulation, and also as low energy stimulation. (reproduced from: Soffer E. Gastric Electrical Stimulation for Gastroparesis. Journal of Neurogastroenterology and Motility 201;18:131–137)