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Gastric Electrical Stimulation for Gastroparesis

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Gastroparesis

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

The first report on electrical stimulation of the gut can be traced back to 1963; Bilgutay and colleagues applied gastric electrical stimulation (GES) via an intraluminal catheter placed in the stomach nasally and reported GES-induced peristalsis by fluoroscopy and a shortened recovery time from ileus after laparotomy in both humans and dogs. These exciting findings were, however, not reproduced in a few subsequent controlled studies. In the late 1960s and early 1970s, a number of investigators began to study gastric myoelectrical activity and its correlation with gastric contractile activity, leading to a better understanding of gastric electrophysiology and further development of GES. In early 1990s, Kelly and colleagues systematically investigated the effects of GES on intrinsic gastric myoelectrical activity or slow waves, gastric contractions, and gastric emptying mostly in dogs. During the past decade, various methods of GES have been developed for the treatment of gastric motility disorders and applied in both patients with gastroparesis and canine models of gastroparesis. According to the stimulus, GES can be classified as short and long pulses. However, limited clinical studies and extensive canine experiments have suggested therapeutic potential of long-pulse GES in treating gastric dysrhythmia and delayed gastric emptying. A number of novel methods have recently been developed for GES, including sequential multichannel GES, dual-pulse GES, and synchronized GES. While there is lack of clinical data due to the unavailability of implantable device, canine studies have demonstrated the viability of these new emerging GES methods in treating gastroparesis.

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References

  1. Bilgutay AM, Wingrove R, Grifen WO, Bonnabeau RC, Lillehei CW. Gastro-intestinal pacing: a new concept in the treatment of ileus. Ann Surg. 1963;158(3):338–48.

    PubMed  CAS  Google Scholar 

  2. Quast DC, Beall AC, DeBakey ME. Clinical evaluation of the gastrointestinal pacer. Surg Gyn Obs. 1965(January):35–37.

    Google Scholar 

  3. Berger T, Kewenter J, Kock NG. Response to gastrointestinal pacing: antral, duodenal and jejunal motility in control and postoperative patients. Ann Surg. 1966;164(1):139–44.

    Article  PubMed  CAS  Google Scholar 

  4. Hinder RA, Kelly KA. Human gastric pacemaker potential: site of orgin, spread, and response to gastric transsaction and proximal gastric vagotomy. Am J Surg. 1977;133:29–33.

    Article  PubMed  CAS  Google Scholar 

  5. Szurszewski JH, Elveback LR, Code CF. Configuration and frequency gradient of electric slow wave over canine small bowel. Am J Physiol. 1970;218:1468–73.

    PubMed  CAS  Google Scholar 

  6. Kelly KA, La Force RC. Pacing the canine stomach with electric stimulation. Am J Physiol. 1972;222(3):588–94.

    PubMed  CAS  Google Scholar 

  7. Soper NJ, Sarr MG, Kelly KA. Human duodenal myoelectric activity after operation and with pacing. Surgery. 1990;107:63–8.

    PubMed  CAS  Google Scholar 

  8. Kelly KA. Pacing the gut. Gastroenterol. 1992;103(6):1967–9.

    CAS  Google Scholar 

  9. Eagon JC, Kelly KA. Effects of gastric pacing on canine gastric motility and emptying. Am J Physiol. 1993;265(4 Pt 1):G767–74.

    PubMed  CAS  Google Scholar 

  10. Miedema BW, Sarr MG, Kelly KA. Pacing the human stomach. Surgery. 1992;111(2):143–50.

    PubMed  CAS  Google Scholar 

  11. Zhang J, Chen JD. Systematic review: applications and future of gastric electrical stimulation. Aliment Pharmacol Ther. 2006;24(7):991–1002.

    Article  PubMed  CAS  Google Scholar 

  12. Abell T, McCallum R, Hocking M, et al. Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology. 2003;125:421–8.

    Article  PubMed  Google Scholar 

  13. McCallum RW, Chen JDZ, Lin ZY, Schirmer BD, Williams RD, Ross RA. Gastric pacing improves emptying and symptoms in patients with gastroparesis. Gastroenterology. 1998;114:456–61.

    Article  PubMed  CAS  Google Scholar 

  14. Chen JDZ, Qian LW, Ouyang H, Yin JY. Gastric electrical stimulation with short pulses reduces vomiting but not dysrhythmia in dogs. Gastroenterology. 2003;124:401–9.

    Article  PubMed  Google Scholar 

  15. Familoni BO, Abell T, Nemoto D, Voeller G, Johnson B. Efficacy of electrical stimulation at frequencies higher than basal rate in canine stomach. Dig Dis Sci. 1997;42:892–7.

    Article  PubMed  CAS  Google Scholar 

  16. Mintchev MP, Sanminguel CP, Bowes KL. Microprocessor controlled movement of liquid gastric content using sequentila neural electrical stimulation. Gut. 1998;43:607–11.

    Article  PubMed  CAS  Google Scholar 

  17. Zhu H, Sallam H, Chen DD, Chen JD. Therapeutic potential of synchronized gastric electrical stimulation for gastroparesis: enhanced gastric motility in dogs. Am J Physiol Regul Integr Comp Physiol. 2007;293:R1875–81.

    Article  PubMed  CAS  Google Scholar 

  18. Cigaina V. Gastric pacing as therapy for morbid obesity: preliminary results. Obes Surg. 2002;12 Suppl 1:12S–6S.

    Article  PubMed  Google Scholar 

  19. Forster J, Sarosiek I, Delcore R, Lin Z, Raju GS, McCallum RW. Gastric pacing is a new surgical treatment for gastroparesis. Am J Surg. 2001;182(6):676–81.

    Article  PubMed  CAS  Google Scholar 

  20. Forster J, Sarosiek I, Lin Z, Durham S, Denton S, Roeser K, et al. Further experience with gastric stimulation to treat drug refractory gastroparesis. Am J Surg. 2003;186(6):690–5.

    Article  PubMed  Google Scholar 

  21. Lin Z, Forster J, Sarosiek I, McCallum RW. Treatment of diabetic gastroparesis by high-­frequency gastric electrical stimulation. Diabetes Care. 2004;27(5):1071–6.

    Article  PubMed  Google Scholar 

  22. Cutts TF, Luo J, Starkebaum W, Rashed H, Abell TL. Is gastric electrical stimulation superior to standard pharmacologic therapy in improving GI symptoms, healthcare resources, and long-term health care benefits? Neurogastroenterol Motil. 2005;17:35–43.

    Article  PubMed  CAS  Google Scholar 

  23. Lin Z, McElhinney C, Sarosiek I, Forster J, McCallum R. Chronic gastric electrical stimulation for gastroparesis reduces the use of prokinetic and/or antiemetic medications and the need for hospitalizations. Dig Dis Sci. 2005;50(7):1328–34.

    Article  PubMed  Google Scholar 

  24. McCallum R, Lin Z, Wetzel P, Sarosiek I, Forster J. Clinical response to gastric electrical stimulation in patients with postsurgical gastroparesis. Clin Gastroenterol Hepatol. 2005;3:49–54.

    Article  PubMed  Google Scholar 

  25. McCallum RW, Dusing RW, Sarosiek I, Cocjin J, Forster J, Lin Z. Mechanisms of symptomatic improvement after gastric electrical stimulation in gastroparetic patients. Neurogastroenterol Motil. 2010;22(2):161–7. e50-1.

    Article  PubMed  CAS  Google Scholar 

  26. van der Voort IR, Becker JC, Dietl KH, Konturek JW, Domschke W, Pohle T. Gastric electrical stimulation results in improved metabolic control in diabetic patients suffering from gastroparesis. Exp Clin Endocrinol Diabetes. 2005;113(1):38–42.

    Article  PubMed  Google Scholar 

  27. Xing JH, Chen JD. Gastric electrical stimulation with parameters for gastroparesis enhances gastric accommodation and alleviates distention-induced symptoms in dogs. Dig Dis Sci. 2006;51:2160–4.

    Article  PubMed  CAS  Google Scholar 

  28. Yu X, Yang J, Hou X, Zhang K, Qian W, Chen JD. Cisplatin-induced gastric dysrhythmia and emesis in dogs and possible role of gastric electrical stimulation. Dig Dis Sci. 2009;54:922–7.

    Article  PubMed  CAS  Google Scholar 

  29. Bauer AJ, Sanders KM. Passive and active membrane properties of canine gastric antral circular muscles. Am J Physiol. 1986;251:C268–73.

    PubMed  CAS  Google Scholar 

  30. Lin ZY, McCallum RW, Schirmer BD, Chen JDZ. Effects of pacing parameters in the entrainment of gastric slow waves in patients with gastroparesis. Am J Physiol (Gastrointest) Liver Physiol. 1998;274:G186–91.

    CAS  Google Scholar 

  31. Qian L, Lin X, Chen JDZ. Normalization of atropine-induced postprandial dysrhythmias with gastric pacing. Am J Physiol. 1999;276:G387–92.

    PubMed  CAS  Google Scholar 

  32. Song GQ, Lei Y, Xu X, Chen JD. Gastric electrical stimulation with long pulses in humans and animals: can data obtained in animals be replicated in humans? Neuromodulation: Technol Neural Interface. 2010;13:87–92.

    Article  Google Scholar 

  33. Hocking MP, Vogel SB, Sninsky CA. Human gastric myoelectrical activity and gastric emptying following gastric surgery and with pacing. Gastroenterology. 1992;103:1811–6.

    PubMed  CAS  Google Scholar 

  34. Li S, Chen JD. Cellular effects of gastric electrical stimulation on antral smooth muscle cells in rats. Am J Physiol Regul Integr Comp Physiol. 2010;298:R1580–7.

    Article  PubMed  CAS  Google Scholar 

  35. Hou XH, Yin JY, Pasricha PJ, Chen JDZ. In vivo gastric and intestinal slow waves in W/Wv mouse. Dig Dis Sic. 2005;50:1335–41.

    Article  Google Scholar 

  36. Daniel EE, Boddy G, Bong A, Cho WJ. A new model of pacing in the mouse intestine. Am J Physiol Gastrointest Liver Physiol. 2004;286:G253–62.

    Article  PubMed  CAS  Google Scholar 

  37. Ouyang H, Xing J, Chen JDZ. Tachygastria induced by gastric electrical stimulation is mediated via α- and β-adrenergic pathway and inhibits antral motility in dogs. Neurogastroenterol Motil. 2005;17:846–53.

    Article  PubMed  CAS  Google Scholar 

  38. Xing JH, Chen JD. Effects and mechanisms of long-pulse gastric electrical stimulation on canine gastric tone and accommodation. Neurogastroenterol Motil. 2006;18:136–43.

    Article  PubMed  CAS  Google Scholar 

  39. Chen JDZ, Xu X, Zhang J, Abo M, Lin XM, McCallum RW, et al. Potential of multi-channel gastric electrical stimulation for gastroparesis: a canine study on its efficiency and efficacy. Neurogastroenterol Motil. 2005;17:878–82.

    PubMed  CAS  Google Scholar 

  40. Song GQ, Hou XH, Yang B, Liu JS, Qian W, Chen JDZ. Two-channel gastric electrical stimulation accelerates delayed gastric emptying induced by vasopressin. Dig Dis Sci. 2005;50:662–8.

    Article  PubMed  CAS  Google Scholar 

  41. Liu J, Qiao X, Chen JD. Therapeutic potentials of a novel method of dual-pulse gastric electrical stimulation for gastric dysrhythmia and symptoms of nausea and vomiting. Am J Surg. 2006;191(2):255–61.

    Article  PubMed  Google Scholar 

  42. Song GQ, Hou X, Yang B, Sun Y, Qian W, Chen JD. A novel method of 2-channel dual-pulse gastric electrical stimulation improves solid gastric emptying in dogs. Surgery. 2008;143:72–8.

    Article  PubMed  Google Scholar 

  43. Lei Y, Chen JD. Effects of dual pulse gastric electrical stimulation on gastric tone and compliance in dogs. Dig Liver Dis. 2009;41:277–82.

    Article  PubMed  CAS  Google Scholar 

  44. Song GQ, Chen JD. Synchronized gastric electrical stimulation improves delayed gastric emptying in nonobese mice with diabetic gastroparesis. J Appl Physiol. 2007;103:1560–4.

    Article  PubMed  Google Scholar 

  45. Chen J, Koothan T, Chen JD. Synchronized gastric electrical stimulation improves vagotomy-induced impairment in gastric accommodation via the nitrergic pathway in dogs. Am J Physiol Gastrointest Liver Physiol. 2009;296:G310–8.

    Article  PubMed  CAS  Google Scholar 

  46. Xu X, Pasricha PJ, Chen JD. Feasibility of gastric electrical stimulation by use of endoscopically placed electrodes. Gastrointest Endosc. 2007;66:981–6.

    Article  PubMed  Google Scholar 

  47. Liu S, Hou X, Chen JD. Therapeutic potential of duodenal electrical stimulation for obesity: acute effects on gastric emptying and water intake. Am J Gastroenterol. 2005;100:792–6.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, University of Texas Medical Branch, Route 0655, Galveston, TX, 77555-0655, USA

    Jiande D. Z. Chen PhD (Professor of Medicine)

  2. Division of Gastroenterology, University of Texas Medical Branch, Galveston, TX, USA

    Jieyun Yin MD (Assistant Professor)

  3. Internal Medicine Department, Texas Tech University Health Sciences Center, Paul L. Foster School of Medicine, El Paso, Texas, USA

    Richard W. McCallum MD

Authors
  1. Jiande D. Z. Chen PhD
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  2. Jieyun Yin MD
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  3. Richard W. McCallum MD
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Corresponding author

Correspondence to Jiande D. Z. Chen PhD .

Editor information

Editors and Affiliations

  1. School of Medicine, Department of Medicine, Temple University, N. Broad St. 3401, Philadelphia, 19140, Pennsylvania, USA

    Henry P. Parkman

  2. Paul L Foster School of Medicine, Department of Internal Medicine, Texas Tech University Health Sciences Ce, Alberta Avenue 4800, El Paso, 77905, Texas, USA

    Richard W. McCallum

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Chen, J.D.Z., Yin, J., McCallum, R.W. (2012). Gastric Electrical Stimulation for Gastroparesis. In: Parkman, H., McCallum, R. (eds) Gastroparesis. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-60761-552-1_29

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  • DOI: https://doi.org/10.1007/978-1-60761-552-1_29

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  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-551-4

  • Online ISBN: 978-1-60761-552-1

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