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Shocking The GI Tract: Electrical Stimulation From Top To Bottom | 107691
ISSN: 2161-069X
Journal of Gastrointestinal & Digestive System
Open Access
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Electrical stimulation of the gastrointestinal tract has been touted as a possible therapy for intestinal motor
dysfunction since 1963 when Bilgutay, et al., reported the use of transluminal electrical stimulation to induce
peristalsis. In the late 1960???s and 1970???s the myoelectrical activity of the gastrointestinal tract was elucidated along
with its relationship to gut contractility. Out of this initial research several clinical applications of gastrointestinal
electrical stimulation have arisen. These include gastric electrical stimulation (GES) for treatment of gastroparesis,
sacral nerve stimulation (SNS) for treatment of fecal incontinence and constipation and electrical stimulation of
the lower esophageal sphincter (LES) for treatment of severe gastroesophageal reflux disease (GERD). GES is a low
energy, high frequency system that stimulates the nerves that innervate the gastric antral muscle. GES improves
nausea and vomiting, decreases medical costs, decreases hospital days and improves quality of life in patients with
gastroparesis refractory to dietary and pharmacological interventions. SNS is a low energy, high frequency system that
directly stimulates the third sacral nerve root. SNS significantly improves severe fecal incontinence and constipation
compared with optimal medical therapy. Electrical stimulation of the LES for treatment of GERD is the newest
electrical stimulation therapy. Studies published in the last two years demonstrate sustained improvement in GERD
outcome and GERD-HRQL, elimination of the need for daily GERD medications and sustained normalization of
esophageal acid exposure compared to standard medical therapy for severe GERD. Electrical stimulation of the
gastrointestinal tract continues to have great potential for many GI disorders.