Electrical Stimulation Therapy for Gastroesophageal Reflux Disease

Rinsma, Nicolaas Fedde; Bouvy, Nicole D.; Masclee, Ad; Conchillo, José M.

doi:10.5056/jnm13137

Cited by 11 publications

(7 citation statements)

References 38 publications

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“…The IPG generates electrical stimulation to the LES 8–12 times per day for 30 minutes per session. 176 Stimulation of the LES in patients with GERD has been shown to increase resting LES pressure without affecting peristalsis or LES relaxation. 177 Although studies demonstrate that EST is safe and effective for refractory GERD at both 1- and 2-year follow-ups, 178 , 179 data is restricted to short-term case series and open-label studies, and further research into the mechanism of action is needed.…”

Section: Treatmentmentioning

confidence: 99%

Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions

Mermelstein¹,

Mermelstein²,

Chait³

2018

CEG

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A significant percentage of patients with gastroesophageal reflux disease (GERD) will not respond to proton pump inhibitor (PPI) therapy. The causes of PPI-refractory GERD are numerous and diverse, and include adherence, persistent acid, functional disorders, nonacid reflux, and PPI bioavailability. The evaluation should start with a symptom assessment and may progress to imaging, endoscopy, and monitoring of esophageal pH, impedance, and bilirubin. There are a variety of pharmacologic and procedural interventions that should be selected based on the underlying mechanism of PPI failure. Pharmacologic treatments can include antacids, prokinetics, alginates, bile acid binders, reflux inhibitors, and antidepressants. Procedural options include laparoscopic fundoplication and LINX as well as endoscopic procedures, such as transoral incisionless fundoplication and Stretta. Several alternative and complementary treatments of possible benefit also exist.

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Section: Treatmentmentioning

confidence: 99%

Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions

Mermelstein¹,

Mermelstein²,

Chait³

2018

CEG

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“…Another laparoscopic procedure is the Endostim method: The Endostim is another laparoscopic surgical procedure [30], which does not at all alter the anatomy of the esophagus-gastric sphincter. The surgical procedure, in fact, only serves to implant electrodes in the distal esophagus.…”

Section: Laparoscopy Vs Openmentioning

confidence: 99%

Updates on Management of GERD Disease

Iannetti¹

2017

J Gastrointest Dig Syst

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Gastro-esophageal reflux disease is a very common disease. Natural history provides an alternative to wellness and reactivating the disease. The purpose of this article is to review the condition of gastroesophageal reflux disease. The article discusses the diagnostic methods, the clinical presentations and the higher incidence of atypical forms and high reflux symptoms. Many patients are not responding to therapy and those who respond to drugs become dependent on the cure. Medical therapy has some adverse events such as anemia, osteoporosis, and infections. Physiotherapy can be an alternative treatment that offers a temporal benefit.Surgical therapy is performed with laparoscopy, which is less invasive than open procedure and reduces the time of stay. Endoscopic surgery is devoid of postoperative complications and is easily executable. It can be carried out with one day residency. The article outlines the various endoscopic techniques of recent years and reports scientific studies. From these it appears that the efficacy of endoscopic therapies for the treatment of GERD has not been documented with certainty. So, despite the dream of resolving gastroesophageal reflux with mini-invasive or, even better, endoscopic surgical procedures, the experience of real life teaches us that the medical therapy is effective in most cases and risk free, if the patient is followed closely.

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“…Although electrostimulation therapy of the lower esophageal sphincter is a relatively new concept for the treatment of patients who are resistant to medication and also, the therapy is safe and effective in short-term and long-term studies in humans [3, 4, 6, 8], there have been no negative side effects to this form of the treatment and it has been proven to provide both significant and sustained relief from the symptoms of GERD while at the same time eliminating the need for PPI medication and reducing esophageal acid exposure. Canine models were first used to study the effects of electrostimulation of the LES in the treatment of GERD [9, 10]. Reports have stated that electric stimulation (20 Hz, pulse width of 3 ms) with 2 pairs of electrodes causing a contraction and increase of the pressure of the sphincter complex was effective in preventing gastroesophageal reflux.…”

Section: Introductionmentioning

confidence: 99%

Wirelessly Powered Endoscopically Implantable Devices into the Submucosa as the Possible Treatment of Gastroesophageal Reflux Disease

Hajer

Novák

Rosina

2019

Gastroenterology Research and Practice

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Gastroesophageal reflux disease (GERD) is a rather common disease with a prevalence reaching up to 10 or 20% in the western world. The most specific symptoms which point to the diagnosis of GERD are feelings of heartburn and the regurgitation of acidic stomach contents into the esophagus. However, a certain number of patients do not respond to standard therapy, and in these cases, it is necessary to resort to other treatment methods, such as laparoscopic fundoplication or electrostimulation of the lower esophageal sphincter. The aim of our work was to design and manufacture a miniature, battery-less stimulator to provide electric stimulation of the lower esophageal sphincter, which could be implanted deep into the submucosa of the distal esophagus. The main goal was to provide a battery-less system as opposed to traditional battery neurostimulators to reduce the size and weight of the device. An electronic prototype of a wirelessly powered implantable device was developed. We used animal models for the experiments. The device is designed to treat GERD via electrical stimulation of the muscularis propria. It is implanted into the submucosal pocket by the lower esophageal sphincter with an endoscope. This method of implantation is superior to esophageal stimulators used today because of very low invasiveness of the surgery. Bipolar neurostimulation via two gold-plated leads is provided. The device does not have any source of energy; it is powered wirelessly which reduces the risk of potential battery leakage and reduces the overall dimensions.

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Electrical Stimulation Therapy for Gastroesophageal Reflux Disease

Cited by 11 publications

References 38 publications

Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions

Proton pump inhibitor-refractory gastroesophageal reflux disease: challenges and solutions

Updates on Management of GERD Disease

Wirelessly Powered Endoscopically Implantable Devices into the Submucosa as the Possible Treatment of Gastroesophageal Reflux Disease

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