Home‐Based Transcutaneous Neuromodulation Improved Constipation via Modulating Gastrointestinal Hormones and Bile Acids

Ge, Zhenyang; Duan, Zhijun; Yang, Hang; Zhang, Shengai; Zhang, Shuang; Wang, Lixia; Yan, Dong; Sun, Xiaoyu; Zhang, Zhifeng; Su, Liping; Zhu, Hong; Zhou, Dongdong; Shi, Honggang; Yu, Jun; Yang, Hui; Chang, Qingyong; Zhang, Nina; Wu, Dongsheng; Chen, Jiande D.Z.

doi:10.1155/2018/2086163

Cited by 12 publications

(12 citation statements)

References 53 publications

(59 reference statements)

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“…(2) Serum lipid: using automatic biochemical analyzer (Hitachi 7600_020 biochemical automatic analyzer) to determine total cholesterol (TC) and triglyceride (TG). (3) Serum BAs: five standard products were accurately weighed and formulated into standard stock solutions with a concentration of 1 mg/ml, which were sequentially diluted with matrix to a mass concentration of 0.2, 1, 5, 10, 50, 100, 500,1000 ng/ml total eight series of standard solutions [ 12 ]. Cryopreserved blood samples were lyophilized and reconstituted with a methanol solution.…”

Section: Methodsmentioning

confidence: 99%

“…In our previous study, TN could improve the excitability of the vagus nerve and inhibit the synthesis and release of inflammatory factors. TN could also regulate the level of gastrointestinal hormone and the metabolism of serum bile acids (BAs) [12]. Moreover, stimulation at both Zusanli and posterior tibial nerve can maximize the advantages of TN [9,12,13].…”

Section: Introductionmentioning

confidence: 99%

“…TN could also regulate the level of gastrointestinal hormone and the metabolism of serum bile acids (BAs) [12]. Moreover, stimulation at both Zusanli and posterior tibial nerve can maximize the advantages of TN [9,12,13]. Other studies have found that stimulation at Zusanli can inhibit inflammation and regulate the immune function of patients [11,14].…”

Section: Introductionmentioning

confidence: 99%

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Transcutaneous Neuromodulation improved inflammation and sympathovagal ratio in patients with primary biliary ssscholangitis and inadequate response to Ursodeoxycholic acid: a pilot study

Yang

Wang

et al. 2020

BMC Complement Med Ther

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Background: At present, ursodeoxycholic acid (UDCA) is internationally recognized as a therapeutic drug in clinic. However, about 40% Primary Biliary Cholangitis (PBC) patients are poor responders to UDCA. It has been demonstrated that Transcutaneous Neuromodulation (TN) can be involved in gut motility, metabolism of bile acids, immune inflammation, and autonomic nerve. Therefore, this study aimed to explore the effect of TN combined with UDCA on PBC and related mechanisms. Methods: According to inclusion and exclusion criteria, 10 healthy volunteers and 15 PBC patients were recruited to control group and TN group, respectively. PBC patients were alternately but blindly assigned to group A (TN combined with UDCA) and group B (sham-TN combined with UDCA), and a crossover design was used. The TN treatment was performed via the posterior tibial nerve and acupoint ST36 (Zusanli) 1 h twice/day for 2 weeks. T test and nonparametric test were used to analyze the data.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transcutaneous Neuromodulation improved inflammation and sympathovagal ratio in patients with primary biliary ssscholangitis and inadequate response to Ursodeoxycholic acid: a pilot study

Yang

Wang

et al. 2020

BMC Complement Med Ther

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“…Because of the dietary requirements and cumbersome stool collections required for measurement of fecal 48-hour bile excretion, patients may not be willing to complete this testing. Abnormal BA levels have been reported in patients with constipation; relative to healthy controls, there was reduced total fecal BAs and, specifically, DCA (which may result in reduced colonic secretion and motility) with increased LCA [33] and increased fasting plasma levels of taurine-conjugated DCA, CA, and LCA [41], which the authors attributed to greater BA reabsorption as a result of constipation.…”

Section: Diagnostic Testing For Changes In Bile Acid Synthesis or Fecmentioning

confidence: 99%

Elobixibat for the treatment of constipation

Chedid

Vijayvargiya

Camilleri

2018

Expert Review of Gastroenterology & Hepatology

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Chronic idiopathic constipation (CC) is highly prevalent worldwide. A subset of patients with CC have reduced fecal (and by inference, intra-colonic) bile acids (BA). Elobixibat, a locally-acting ileal bile acid transporter (IBAT) inhibitor, leads to increased BA delivery to the colon and represents a new class of treatment for CC. BAs accelerate colonic transit and increase colonic secretion. Therefore, IBAT inhibitors have potential to treat patients with CC. Areas covered: Rationale for IBAT inhibitor in therapeutics, and preclinical and clinical pharmacology of elobixibat: In vitro, elobixibat is a highly potent, selective IBAT inhibitor. In humans, elobixibat accelerated colonic transit. In phase 2A, 2B and 3 studies in CC, elobixibat was efficacious, well tolerated and safe. An open-label, phase 3 trial (52 weeks) confirmed the safety of elobixibat. Elobixibat reduces LDL cholesterol, increases serum GLP-1, and has potential in metabolic syndrome. Expert commentary: Uniquely among current treatments of CC, elobixibat stimulates both motor and secretory functions in the colon. These dual effects suggest that, when approved, elobixibat may be a first-line choice for constipation associated with colonic BA deficiency and a second-line treatment for all patients with CC and constipation-predominant irritable bowel syndrome. Further studies are required to confirm efficacy for relief of CC. Once approved, elobixibat will likely become a second-line choice for treatment of CC.

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“…Moreover, a potential effect on hormonal gut activity has been reported. A 4-week transcutaneous tibial nerve treatment significantly increased plasma levels of 5-HT and motilin and decreased the plasma level of somatostatin in patients with functional constipation, reducing the value of bile acids (taurocholic, taurocholic deoxycholate and taurocholic lithocholic) [11].…”

Section: Introductionmentioning

confidence: 96%

The role of tibial nerve stimulation for enhanced postoperative recovery after colorectal surgery: a double-blind, parallel-group, randomized controlled trial

et al. 2020

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Background Postoperative ileus (POI) is the most common cause of prolonged hospital stay following abdominal surgery, despite an optimized enhanced recovery after surgery (ERAS) program. The aim of the study was to evaluate the role of postoperative transcutaneous electrical tibial nerve stimulation (TTNS) in the recovery of bowel function and in shortening hospital stay after colonic resection. Methods Patients having elective laparoscopic colonic surgery within an ERAS program at our institution between June 2016 and June 2019 were enrolled and randomly assigned to a treatment protocol with TTNS or sham electrical stimulation. The primary endpoint was the time of recovery of gastrointestinal motility, measured as the first passage of stool. Secondary endpoints included: first passage of flatus, length of hospital stay, and complication rate related to the use of TTNS. Results One hundred and seventy patients who had right hemicolectomy (median age 71 years (range 43-89 years); 47.5% women) and 170 patients who had left colectomy (median age 67 years range (37-92 years); 41.5% women) were enrolled. The only factor significantly affected by TTNS was time to first passage of flatus after right hemicolectomy (reduced from 46 to 33 h, p = 0.04). However, if only patients with low compliance to early oral nutrition (63 of 340; 18.5%) were considered, a statistically significant difference in time until first flatus (p < 0.01) and first bowel movement (p < 0.0001) and a shorter time until discharge (median 5 vs 7 days) were found in both left and right colectomies groups, respectively. Conclusions TTNS may have a positive effect on gastrointestinal tract motility and recovery from POI after colorectal surgery in a selected group, who has low compliance with an ERAS program, without increasing the risk of complications.

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Home‐Based Transcutaneous Neuromodulation Improved Constipation via Modulating Gastrointestinal Hormones and Bile Acids

Cited by 12 publications

References 53 publications

Transcutaneous Neuromodulation improved inflammation and sympathovagal ratio in patients with primary biliary ssscholangitis and inadequate response to Ursodeoxycholic acid: a pilot study

Transcutaneous Neuromodulation improved inflammation and sympathovagal ratio in patients with primary biliary ssscholangitis and inadequate response to Ursodeoxycholic acid: a pilot study

Elobixibat for the treatment of constipation

The role of tibial nerve stimulation for enhanced postoperative recovery after colorectal surgery: a double-blind, parallel-group, randomized controlled trial

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