Gastro-intestinal Pacing*

Am, Bilgutay; Wingrove, R. C.; Wo, Griffen; Rc, Bonnabeau; Cw, Lillehei

doi:10.1097/00000658-196315830-00003

Cited by 108 publications

(16 citation statements)

References 4 publications

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“…Pioneer work done by Bilgutay et al has investigated the possibilities of using electrical stimulation on GI organs to improve GI motility dysfunctions [ 3 ]. More recently, gastric electrical stimulation (GES) using an implantable neurostimulator (Enterra Therapy ITREL 3 model 7425G; Medtronic Inc., Minneapolis, MN, USA), received a humanitarian device exemption for the management of patients suffering from nausea.…”

Section: Introductionmentioning

confidence: 99%

A Wireless Implant for Gastrointestinal Motility Disorders

Lo¹,

Wang

Dubrovsky

et al. 2018

Micromachines

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Implantable functional electrical stimulation (IFES) has demonstrated its effectiveness as an alternative treatment option for diseases incurable pharmaceutically (e.g., retinal prosthesis, cochlear implant, spinal cord implant for pain relief). However, the development of IFES for gastrointestinal (GI) tract modulation is still limited due to the poorly understood GI neural network (gut–brain axis) and the fundamental difference among activating/monitoring smooth muscles, skeletal muscles and neurons. This inevitably imposes different design specifications for GI implants. This paper thus addresses the design requirements for an implant to treat GI dysmotility and presents a miniaturized wireless implant capable of modulating and recording GI motility. This implant incorporates a custom-made system-on-a-chip (SoC) and a heterogeneous system-in-a-package (SiP) for device miniaturization and integration. An in vivo experiment using both rodent and porcine models is further conducted to validate the effectiveness of the implant.

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Section: Introductionmentioning

confidence: 99%

A Wireless Implant for Gastrointestinal Motility Disorders

Lo¹,

Wang

Dubrovsky

et al. 2018

Micromachines

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“…Bilgutay et al9 tested the use of electrical stimulation of the GI tract to treat ileus, and found that application of electrical stimuli to the stomach, via the tip of a nasogastric tube, resulted in augmentation of gastric contractions and increased gastric emptying, as assessed by fluoroscopy. This initial impression was not confirmed by subsequent randomized controlled studies, that failed to show a significant effect of electrical stimulation on the duration of postoperative ileus 10,11.…”

Section: The Evolution Of Gastric Electrical Stimulationmentioning

confidence: 99%

Gastric Electrical Stimulation for Gastroparesis

Soffer¹

2012

J Neurogastroenterol Motil

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Gastric electrical stimulation (GES) for gastroparesis has been in use for more than a decade. Multiple publications, consisting almost entirely of open label single center studies, reported a beneficial effect on symptoms, quality of life and nutritional status. Some predictors of better response to GES have been lately identified, primarily diabetic etiology and nausea and vomiting as the predominant symptoms. However, individual response to GES remains difficult to predict. The mechanism of action of GES remains poorly understood. Stimulation parameters approved in clinical practice do not regulate gastric slow wave activity and have inconsistent effect on gastric emptying. Despite such limitations, gastric electrical stimulation remains a helpful intervention in some patients with severe gastroparesis who fail to respond to medical therapy.

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“…Most pacing studies have attempted to entrain slow waves in the normal (aboral) direction, aiming to promote gastric motility when it is deficient, as in postoperative ileus99 or gastroparesis 100, 101. One noncontrolled human gastroparesis trial to date has demonstrated the therapeutic feasibility of gastric pacing, by demonstrating significantly decreased gastric retention, reduced symptoms, and a decreased need for supplemental jejunostomy feeding in treated patients 101.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Gastrointestinal system

Cheng

O’Grady

et al. 2010

WIREs Mechanisms of Disease

119

106

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The functions of the gastrointestinal (GI) tract include digestion, absorption, excretion, and protection. In this review, we focus on the electrical activity of the stomach and small intestine, which underlies the motility of these organs, and where the most detailed systems descriptions and computational models have been based to date. Much of this discussion is also applicable to the rest of the GI tract. This review covers four major spatial scales: cell, tissue, organ, and torso, and discusses the methods of investigation and the challenges associated with each. We begin by describing the origin of the electrical activity in the interstitial cells of Cajal, and its spread to smooth muscle cells. The spread of electrical activity through the stomach and small intestine is then described, followed by the resultant electrical and magnetic activity that may be recorded on the body surface. A number of common and highly symptomatic GI conditions involve abnormal electrical and/or motor activity, which are often termed functional disorders. In the last section of this review we address approaches being used to characterize and diagnose abnormalities in the electrical activity and how these might be applied in the clinical setting. The understanding of electrophysiology and motility of the GI system remains a challenging field, and the review discusses how biophysically based mathematical models can help to bridge gaps in our current knowledge, through integration of otherwise separate concepts.

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Gastro-intestinal Pacing*

Cited by 108 publications

References 4 publications

A Wireless Implant for Gastrointestinal Motility Disorders

A Wireless Implant for Gastrointestinal Motility Disorders

Gastric Electrical Stimulation for Gastroparesis

Gastrointestinal system

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