Gastric or intestinal electrical stimulation-induced increase in gastric volume is correlated with reduced food intake
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Abstract:
Objective. Satiation has recently been shown to be associated with gastric volume or gastric tone. Electrical stimulation has been shown to reduce food intake and increase gastric volume, or reduce gastric tone. The aim of this study was to investigate the correlation between gastric or intestinal electrical stimulation (GES/IES)-induced increase in gastric volume and food intake. Material and methods. GES/IES was performed on 14 dogs implanted with electrodes and a gastric cannula. Food intake was measured and gastric volume was assessed using barostat with or without GES/IES. Results. Food intake was correlated to weight (r=0.62, p = 0.02) as well as the fasting gastric volume (r=0.59, p=0.02). GES/IES reduced food intake (240.8 versus 445.0 g, p<0.005) and increased gastric volume in the fasting state (263.4 versus 74.4 ml, p<0.0001). Reduced food intake was correlated to the preprandial gastric volume (r= − 0.58, p=0.02) and postprandial increase in gastric volume with GES/IES (r=0.56, p=0.03). Conclusions. GES/IES reduces food intake and increases gastric volume measured by barostat. The GES/IES-induced increase in gastric volume (or reduced gastric tone) is correlated with reduced food intake during GES/IES.Keywords:
Barostat
Gastric Content
Objective. Satiation has recently been shown to be associated with gastric volume or gastric tone. Electrical stimulation has been shown to reduce food intake and increase gastric volume, or reduce gastric tone. The aim of this study was to investigate the correlation between gastric or intestinal electrical stimulation (GES/IES)-induced increase in gastric volume and food intake. Material and methods. GES/IES was performed on 14 dogs implanted with electrodes and a gastric cannula. Food intake was measured and gastric volume was assessed using barostat with or without GES/IES. Results. Food intake was correlated to weight (r=0.62, p = 0.02) as well as the fasting gastric volume (r=0.59, p=0.02). GES/IES reduced food intake (240.8 versus 445.0 g, p<0.005) and increased gastric volume in the fasting state (263.4 versus 74.4 ml, p<0.0001). Reduced food intake was correlated to the preprandial gastric volume (r= − 0.58, p=0.02) and postprandial increase in gastric volume with GES/IES (r=0.56, p=0.03). Conclusions. GES/IES reduces food intake and increases gastric volume measured by barostat. The GES/IES-induced increase in gastric volume (or reduced gastric tone) is correlated with reduced food intake during GES/IES.
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The assessment of gastric accommodation and emptying by different methodologies provides inconsistent results. We aimed to compare magnetic resonance imaging (MRI), barostat and 13C-acetate breath test (BT) for the assessment of gastric volume responses and emptying in healthy controls (HC) and patients with functional dyspepsia (FD). Eight HC and eight FD patients underwent: (i) continuous BT with simultaneous MRI in the upright position after ingestion of isocaloric, 300 kcal, 200 and 800 mL meals, both labelled with 100 mg of (13)C-acetate; and (ii) BT with gastric barostat after ingestion of the 200 mL meal. MRI measured total gastric volume and gastric content volume (GCV) at baseline, after filling and during emptying. Meal emptying half-times (T(1/2)) for MRI and BT were calculated (mean +/- SD). We found: (i) Initial GCV was lower in FD than in HC (762 +/- 22 vs 810 +/- 52 mL, P < 0.04) after the 800 mL meal but not the 200 mL meal. T(1/2)(MRI) was shorter for the 800 mL than the 200 mL meal (P < 0.001), but similar in HC and FD (200 mL: HC 117 +/- 30 min vs FD 138 +/- 42 min, ns; 800 mL: HC 71 +/- 16 min vs FD 78 +/- 27 min, ns). In contrast, T(1/2)(BT) was similar between meals and groups (200 mL: HC 111 +/- 11 min vs FD 116 +/- 19 min; 800 mL: HC 114 +/- 14 min vs FD: 113 +/- 17 min). (ii) Barostat measurements showed similar postprandial volume increases between groups. We conclude that direct measurements by MRI provide a sensitive, non-invasive assessment of gastric accommodation and emptying after a meal. In contrast to MRI, BT did not detect faster emptying of high-volume compared to low-volume liquid nutrient meals in HC or FD.
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It remains unclear whether postprandial symptom profiles in patients with visceral hypersensitivity and in those with impaired fundic accommodation differ. Therefore, we evaluated the postprandial symptoms in functional dyspepsia (FD) patients classified according to proximal stomach function. In addition, the effect of gastric relaxation induced by sumatriptan on postprandial symptoms was studied in FD patients with impaired fundic accommodation.Twenty-five healthy volunteers (HVs) and 44 FD patients filled out a disease-specific questionnaire (Nepean Dyspepsia Index) and underwent a gastric barostat study to evaluate visceral sensitivity, meal-induced fundic relaxation, and postprandial symptoms. Postprandial symptoms evoked by a drink test or reported during the barostat study were compared between FD patients subdivided according to the underlying pathophysiological mechanism. Finally, the effect of sumatriptan on postprandial symptoms evoked by a drink test was investigated in HVs and in FD patients with impaired fundic accommodation.There was no clear relationship between any of the 15 Nepean Dyspepsia Index symptoms and proximal stomach function. Postprandial symptoms evoked during the barostat study or after the drink tests were significantly higher in FD patients than in HVs; however, no clear differences in symptom profile could be demonstrated between the different subclasses of FD. Sumatriptan did not affect the maximal ingested volume or the postprandial symptoms in HVs or FD patients after a drink test.No clear relationship could be demonstrated between postprandial symptoms and proximal stomach function.
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