Postoperative ileus increases healthcare costs and reduces the postoperative quality of life (QOL). The aim of this study is to investigate effects and mechanisms of electroacupuncture (EA) at ST36 and PC6 on gastrointestinal motility in rat model of postoperative ileus.Laparotomy was performed in 24 rats (control [n = 8], sham-EA [n = 8], and EA [n = 8]) for the implantation of electrodes in the stomach and mid-jejunum for recording of gastric and small intestinal slow waves. Electrodes were placed in the chest skin for electrocardiogram (ECG). Intestinal manipulation (IM) was performed in Sham-EA and EA rats after surgical procedures. Small intestinal transit (SIT), gastric emptying (GE), postoperative pain, and plasma TNF-α were evaluated in all rats.(1) Compared with sham-EA, EA accelerated both SIT (P < 0.05) and GE (P < 0.05) and improved regularity of small intestinal slow waves. (2) Compared with the control rats (no IM), IM suppressed vagal activity and increased sympathovagal ratio assessed by the spectral analysis of heart rate variability from ECG, which were significantly prevented by EA. (3) EA significantly reduced pain score at 120 minutes (P < 0.05, vs 15 minutes) after the surgery, which was not seen with sham-EA. (4) Plasma TNF-α was increased by IM (P = 0.02) but suppressed by EA (P = 0.04) but not sham-EA.The postoperative ileus induced by IM, EA at ST36 and PC6 exerts a prokinetic effect on SIT and GE, a regulatory effect on small intestinal slow waves and an analgesic effect on postoperative pain possibly mediated via the autonomic-cytokine mechanisms.
The primary aim of this study was to investigate the effects of different audio stimulations on gastric myoelectrical activity and sympathovagal balance in adolescents compared with adults.The study was performed in 11 adults and 12 adolescents. Each subject underwent two sessions, one for classical music, and the other for noise. Each session consisted of 30 min of baseline, 30 min of fasting audio stimulation, a test meal, 30 min of fed audio stimulation, and 30 min of recovery. Electrocardiogram and electrogastrogram were both recorded throughout each session.(i) In the fasting state, both classical music and noise impaired gastric slow wave activity in adolescents. In adults, noise had no effects while classical music moderately improved slow wave rhythmicity. (ii) In the fed state, neither noise nor music had any effects on gastric slow waves. (iii) In the fasting state, both noise and music increased the sympathovagal balance in adolescents; in adults only noise had such an effect. (iv) The test meal increased the sympathovagal balance in all groups.Gastric slow waves and the sympathovagal balance are more strongly affected by audio stimulation in adolescents than in adults. The test meal normalizes the audio stimulation-induced differences between the groups.
Introduction: Gastrointestinal (GI) motility disorders are common in clinical settings, including esophageal motility disorders, gastroesophageal reflux disease, functional dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction, post-operative ileus, irritable bowel syndrome, diarrhea and constipation. While a number of drugs have been developed for treating GI motility disorders, few are currently available. Emerging electrical stimulation methods may provide new treatment options for these GI motility disorders.Areas covered: This review gives an overview of electrical therapies that have been, and are being developed for GI motility disorders, including gastroesophageal reflux, functional dyspepsia, gastroparesis, intestinal motility disorders and constipation. Various methods of gastrointestinal electrical stimulation are introduced. A few methods of nerve stimulation have also been described, including spinal cord stimulation and sacral nerve stimulation. Potentials of electrical therapies for obesity are also discussed. PubMed was searched using keywords and their combinations: electrical stimulation, spinal cord stimulation, sacral nerve stimulation, gastrointestinal motility and functional gastrointestinal diseases.Expert commentary: Electrical stimulation is an area of great interest and has potential for treating GI motility disorders. However, further development in technologies (devices suitable for GI stimulation) and extensive clinical research are needed to advance the field and bring electrical therapies to bedside.
Abstract Background Vagal nerve stimulation (VNS) was reported to have a therapeutic potential for inflammatory bowel disease (IBD). This study was designed to determine effects and mechanisms of SNS on colonic inflammation of in rodent models of IBD and compare the difference among SNS, VNS, and SNS plus VNS. Methods Intestinal inflammation in rats was induced by intrarectal administration of TNBS (2,4,6‐Trinitrobenzenesulfonic acid) on the first day. Five days after intrarectal TNBS, the rats were treated with sham‐VNS, VNS, Sham‐SNS, SNS, and SNS + VNS for 10 days. In another experiment, after 10 days of 4% DSS (dextran sodium sulfate) in drinking water, rats were treated with 10‐day sham‐SNS and SNS. Various inflammatory responses were assessed; mechanisms involving autonomic functions and inflammatory cytokines were investigated. Key Results (a) VNS, SNS, and VNS + SNS significantly and equally decreased the disease activity index and macroscopic scores, and normalized colon length; (b) IL‐10 was decreased by TNBS but increased with SNS, VNS, and SNS + VNS; pro‐inflammatory cytokines, IL‐6, IL‐17A, MCP‐1 and TNF‐α, were increased by TNBS but decreased with SNS, VNS, and SNS + VNS ( P < .05); MPO activity was decreased by SNS, VNS, and SNS + VNS; (c) SNS, VNS, and SNS + VNS remarkably increased vagal activity that was suppressed by TNBS ( P < .05); (d) smilar SNS effects were noted in rats with DSS‐induced colitis. Conclusions & Inferences SNS presents similar anti‐inflammatory effects as VNS by inhibiting pro‐inflammatory cytokines and increasing anti‐inflammatory cytokines via the autonomic pathway. Similar to VNS, SNS may also have a therapeutic potential for colonic inflammation.
Abstract Background The aim of this study was to investigate whether transcutaneous electrical acustimulation (TEA) synchronized with inspiration (STEA), a method known to enhance vagal activity, was more effective than TEA in improving cold stress‐induced impairment in gastric accommodation (GA) and dyspeptic symptoms in healthy subjects. Methods Each of fifteen healthy subjects was studied in five randomized sessions: control (warm nutrient liquid), cold nutrient liquid (CNL), CNL+sham‐TEA, CNL+TEA, and CNL+STEA. The subjects were requested to drink Ensure until reaching maximum satiety. STEA was performed using the same parameters as TEA but asking the subjects to breathe in when they sensed each stimulation train. The electrogastrogram (EGG) and electrocardiogram (ECG) were recorded to assess gastric slow waves (GSW) and autonomic functions, respectively. Key Results GA was reduced with the CNL in comparison with the warm drink but increased with TEA and STEA; STEA was more potent than TEA in improving GA; STEA was more potent in improving GSW than TEA; STEA significantly increased vagal activity and decreased sympathetic activity compared with TEA. Conclusions and Inferences TEA synchronized with inspiration is more potent than TEA in improving cold stress‐induced impairment in GA and GSW and dyspeptic symptoms and might be a novel noninvasive therapy for treating stress‐induced dysmotility and dyspeptic symptoms.
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