Efficacy of needleless transcutaneous electroacupuncture in synchronization with breathing for symptomatic idiopathic gastroparesis: A blinded and controlled acute treatment trial

Guan, Song; Sun, Yan; Bashashati, Mohammad; Sigaroodi, Solmaz; Sarosiek, Irene; Chen, J. D. Z.; McCallum, Richard W.

doi:10.1111/nmo.13361

Cited by 13 publications

(9 citation statements)

References 33 publications

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“…Inflammatory cells which have been evaluated in IBS include mast cells, eosinophils, and lymphocytes, particularly T cells. Mast cells have been highly implicated in IBS pathogenesis in both IBS-C and IBS-D 9 , 10 . IBS has been associated with an increase in the density of degranulating mast cells, while the density of mast cells in close proximity to enteric nerves correlates with abdominal pain severity 11 .…”

Section: Introductionmentioning

confidence: 99%

The relationship between mucosal inflammatory cells, specific symptoms, and psychological functioning in youth with irritable bowel syndrome

Singh

Schurman

et al. 2020

Sci Rep

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Both mucosal inflammation and psychologic dysfunction have been implicated in irritable bowel syndrome (IBS). While some relationships between inflammation (mast cells and eosinophils) and depression have been reported in adults with IBS, relationships between inflammation and psychologic function have not been studied in children and adolescents. The aims of the current study were to: (1) assess densities of colonic mast cells, eosinophils, and TH17 cells in youth with IBS; and, (2) explore relationships between these cells and specific IBS symptoms and psychologic functioning. Utilizing previously obtained biopsies from the descending and rectosigmoid colons, densities were determined for mast cells, eosinophils, and TH17 cells, respectively, in 37 youth with IBS and 10 controls. In IBS patients, densities were assessed in relation to specific IBS symptoms and in relation to self-report anxiety and depression scores. In both the descending and rectosigmoid colons, densities of mast cells, eosinophils, and TH17 cells were higher in IBS patients as compared to controls. In IBS patients, rectosigmoid mast cell density was higher in those reporting pain relief with defecation. Also, in IBS patients, rectosigmoid eosinophilia was associated with higher anxiety scores and eosinophil density correlated with depression scores. In the descending colon, eosinophil and mast cell densities both correlated with depression scores. In conclusion, mucosal inflammation (mast cells and eosinophils) is associated with pain relief with defecation and with anxiety and depression in youth with IBS. Chronic or recurrent abdominal pain affects a substantial proportion of children and adolescents 1,2. The majority of youth with chronic abdominal pain will not have an identified organic disease but will report symptoms consistent with one of the functional gastrointestinal disorders (FGIDs) as defined by Rome criteria 3,4. There are four pain related FGIDs with irritable bowel syndrome (IBS) being one of the two most common 5. Rome IV, the most current version of Rome criteria, defines IBS by the presence of one of the following symptoms: pain related to defecation, pain associated with a change in stool frequency, or pain associated with a change in stool form 4. IBS is further subcategorized as IBS with predominant constipation (IBS-C), IBS with predominant diarrhea (IBS-D), mixed IBS with alternating constipation and diarrhea (IBS-M), and as unsubtyped 4,6. Among a variety of other factors, visceral hyperalgesia, inflammation and psychosocial factors have been highly implicated in the pathogenesis of IBS 7,8. Inflammatory cells which have been evaluated in IBS include mast cells, eosinophils, and lymphocytes, particularly T cells. Mast cells have been highly implicated in IBS pathogenesis in both IBS-C and IBS-D 9,10. IBS has been associated with an increase in the density of degranulating mast cells, while the density of mast cells in close proximity to enteric nerves correlates with abdominal pain severity 11 .

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Section: Introductionmentioning

confidence: 99%

The relationship between mucosal inflammatory cells, specific symptoms, and psychological functioning in youth with irritable bowel syndrome

Singh

Schurman

et al. 2020

Sci Rep

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“…Clinical manifestations include loss of appetite, nausea, paroxysmal vomiting, abdominal discomfort, and abdominal distension. A large number of modern clinical trials have proved that acupuncture is effective in the treatment of gastroparesis [17,18]. In recent years, the clinical studies of gastroparesis are mostly compared with the acupuncture group and the modern medicine group.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Randomized Controlled Trial of Acupuncture Treatment of Gastroparesis Using Different Acupoints

et al. 2020

Pain Research and Management

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Objective. To explore the effect of “selecting acupoints by site” on the synergy effect of “acupoint compatibility” according to the clinical efficacy of acupuncture treatment of patients with gastroparesis. Methods. A total of 99 patients who met the diagnostic criteria for gastroparesis were enrolled in 3 clinical centers and randomly divided into group A (33 cases), group B (33 cases, 1 case of shedding), and group C (33 cases, 1 case of shedding). In group A, acupuncture was performed at Zhongwan (CV 12) and Zusanli (ST 36); in group B, acupuncture was performed at Neiguan (PC 6) and Zusanli (ST 36); in group C, acupuncture was performed at nonacupoint and Zusanli (ST 36). Treatment was performed for 30 minutes every day, 5 days as a course of treatment. There were 2 days off between courses and three courses in total. Differences in a main symptom index of gastroparesis (GCSI) scores, 9 symptom scores, and a health questionnaire (SF-36) were compared between each group before and after treatment and 4 weeks after the end of treatment. The difference of gastric emptying rate was compared before and after treatment. Results. The GCSI scores of each group after treatment and at follow-up were significantly lower than those before treatment (P<0.01), and the reduction in group A was greater than that of groups B and C (P<0.01). The score of each symptom was meaningfully lower than that before treatment (P<0.01 or P<0.05). The effect was best in group A, followed by group B. After treatment, the barium meal in the stomach of the three groups was significantly reduced compared with before treatment (P<0.01). There was no statistical difference between the groups. The results of SF-36 showed that acupuncture treatment can improve health status, to a certain extent, and there was no significant difference in the three groups. Conclusion. (1) Acupuncture is an effective method for the treatment of gastroparesis. (2) The combination of Zhongwan (CV 12) with Zusanli (ST 36) showed the most promising effect on relief of the symptoms in patients with gastroparesis. (3) “Selecting acupoints by site” is the key factor affecting the synergy effect of “acupoint compatibility.” This trial was registered with the International Center for Clinical Trials (registration no. NCT02594397).

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“…While it has been previously proposed that an imbalance between them may contribute to GI dysmotility, current knowledge suggests that their relationship is more complex and involves dynamic interactions, rather than a simple balanced model 45 . It is believed that TES such as tVNS, TEA, and TENS works by modulating the ANS 13,16,46,47 . The vagus nerve and sacral plexus are part of the PNS and play an important role in regulating interactions between the central nervous system and the GI tract, including functions of the esophagus, stomach, small bowel, and colon.…”

Section: Mechanisms Of Actionmentioning

confidence: 99%

“…TES has been studied as an adjunct or an alternative therapy for these conditions (Table 2). 8,23,31,47,78,79 …”

Section: Gastric Motility Disordersmentioning

confidence: 99%

“…Transcutaneous electrical acustimulation treatment in patients with gastroparesis improved overall nausea and vomiting, gastric dysrhythmia, and vagal activity 23,31,47 . Huang et al 23 demonstrated that TEA (compared to sham stimulation) improved impaired gastric accommodation (731.0 ± 185.7 vs. 539.2 ± 133.8 mL, p = 0.005) and increased the percentage of normal gastric slow waves ( p < 0.05) in 13 healthy volunteers consuming a cold liquid challenge.…”

Section: Gastric Motility Disordersmentioning

confidence: 99%

See 1 more Smart Citation

Transcutaneous electrical stimulation for gastrointestinal motility disorders

Song,

Trujillo,

et al. 2023

Neurogastroenterology Motil

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Background/PurposeGastrointestinal (GI) dysmotility is categorized by muscle or nerve dysfunctions in any portion of the GI tract, which leads to abnormalities in GI motor and sensory function. Symptoms may vary depending on the organ affected and can be debilitating. Treatment usually involves diet and lifestyle changes. Pharmacotherapy is limited in effectiveness with various side effects. Transcutaneous electrical stimulation (TES), a noninvasive, needleless technique that provides electrical stimulation using cutaneous non‐needle electrodes, has become increasingly popular. It has been shown to be beneficial in treating GI motility disorders.MethodsThis review paper navigates through the different TES techniques, including transcutaneous peripheral nerve (vagal/sacral/tibial nerves) electrical stimulation, transcutaneous electrical acustimulation (stimulation via acupuncture point), transcutaneous interferential current therapy, and transcutaneous electrical nerve stimulation.Key ResultsAs we delve deeper, we explore the promising effects of TES on dysphagia, gastroesophageal reflux disease, functional dyspepsia, gastroparesis, postoperative ileus, constipation, and irritable bowel syndrome. The literature at hand speaks volumes about the therapeutic prowess of this noninvasive technique.Conclusion & InferencesThe time is ripe to evaluate further the full therapeutic potential of TES, a noninvasive, nonpharmaceutical, nonsurgical, and home‐based self‐administrative technique in managing GI motility disorders.

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Efficacy of needleless transcutaneous electroacupuncture in synchronization with breathing for symptomatic idiopathic gastroparesis: A blinded and controlled acute treatment trial

Cited by 13 publications

References 33 publications

The relationship between mucosal inflammatory cells, specific symptoms, and psychological functioning in youth with irritable bowel syndrome

The relationship between mucosal inflammatory cells, specific symptoms, and psychological functioning in youth with irritable bowel syndrome

A Clinical Randomized Controlled Trial of Acupuncture Treatment of Gastroparesis Using Different Acupoints

Transcutaneous electrical stimulation for gastrointestinal motility disorders

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