Intestinal Pacing for Canine Postgastrectomy Dumping

Becker, James M.; Sava, P; Kelly, Keith A.; Shturman, Leonid

doi:10.1016/s0016-5085(83)80137-1

Cited by 30 publications

(14 citation statements)

References 7 publications

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“…Becker et al. found low frequency–long pulse intestinal pacing was able to delay gastric emptying in canines with postgastrectomy dumping 27 and Miedema et al. reported that forward pacing of the Roux limb could improve the slowed gastric emptying of solids in dogs after gastrectomy 31…”

Section: Discussionmentioning

confidence: 99%

“…Becker et al. found that intestinal pacing delayed gastric emptying and improved the postgastrectomy dumping syndrome in dogs 27 . Miedema and Kelly reported that Roux pacing and the uncut Roux operation abolished ectopic pacemakers in the Roux limb and improved the slowed gastric emptying present in unpaced control tests 31 .…”

Section: Introductionmentioning

confidence: 99%

“…Gastric electrical stimulation (GES) has received increasing attention among researchers and clinicians in recent years and a number of studies have been involved to investigate the effects of GES on gastric myoelectrical activity, gastric motility, gastric emptying and gastrointestinal symptoms 17–33 . Although the results of various studies are sometimes conflicting, which could be attributed to different stimulation parameters, most of data have consistently demonstrated that (i) long pulse–low frequency GES (pulse width in the order of ms) with appropriate parameters is able to entrain gastric slow waves in both humans 19, 25 and dogs; 21, 22 enhance gastric emptying in patients with gastroparesis 17 or canine models of gastroparesis, 20 but not in healthy dogs; 22 induce gastric relaxation in dogs; 33 and improve gastrointestinal symptoms in patients with gastroparesis; 17 (ii) short pulse–high frequency GES (pulse width in the order of μ s) does not alter gastric myoelectrical activity or gastric emptying but improves symptoms of nausea and vomiting in patients with gastroparesis, 28,29 and in dogs 30 .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of vasopressin and long pulse–low frequency gastric electrical stimulation on gastric emptying, gastric and intestinal myoelectrical activity and symptoms in dogs

Brining

Chen

2005

Neurogastroenterology Motil

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The aim of this study was to investigate the effect of vasopressin and long pulse-low frequency gastric electrical stimulation (GES) on gastric emptying, gastric and intestinal myoelectrical activity and symptoms in dogs. The study was performed in eight healthy female dogs implanted with four pairs of gastric serosal electrodes and two pairs of small bowel serosal electrodes, and a duodenal fistula for the assessment of gastric emptying. Each dog was studied in three sessions on three separate days in a randomized order with recordings of gastric and small bowel slow waves. Each study session consisted of 30-min baseline, 30-min stimulation and 30-min recovery period. In sessions 1 and 2, infusion of either saline or vasopressin (0.75 U kg(-1) in 30 mL saline instilled in 30 min) was given during the second 30-min period. The protocol of session 3 was the same as session 2 except long pulse-low frequency GES was performed during the second 30-min period. It was found that: (i) Vasopressin significantly delayed gastric emptying 30 and 45 min after meal and GES did not improve the vasopressin induced delayed gastric emptying; (ii) Vasopressin induced gastric dysrhythmias and GES significantly improved vasopressin induced gastric dysrhythmia; (iii) Vasopressin also induced intestinal slow wave abnormalities but GES had no effect on vasopressin induced small bowel dysrhythmia; (iv) Vasopressin induced symptoms and behaviours suggestive of nausea that were not improved by GES. We conclude that: (i) Vasopressin delays gastric emptying and induces gastric and small bowel dysrhythmias and symptoms in the fed state, and (ii) long pulse-low frequency GES normalizes vasopressin induced gastric dysrhythmia with no improvement in gastric emptying or symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of vasopressin and long pulse–low frequency gastric electrical stimulation on gastric emptying, gastric and intestinal myoelectrical activity and symptoms in dogs

Brining

Chen

2005

Neurogastroenterology Motil

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show abstract

“…17 The major mechanisms involved with long-pulse GES are believed to be largely myogenic. 16 While GES is proposed to treat patients with gastric motility disorders or nausea and vomiting associated with gastroparesis, intestinal electrical stimulation (IES) has also been proposed for treating disorders associated with motility of the small intestine, such as dumping syndrome 18,19 and delayed intestinal transit. 20 Long-pulse IES has been shown to normalize gastric and intestinal dysrhythmia.…”

Section: Introductionmentioning

confidence: 99%

Intestinal electrical stimulation improves delayed gastric emptying and vomiting induced by duodenal distension in dogs

Chen

2007

Neurogastroenterology Motil

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The aim of this study was to investigate the effects of short-pulse intestinal electrical stimulation (IES) on duodenal distention-induced delayed gastric emptying and vomiting in dogs and its possible mechanisms. The study was performed in 12 dogs with jejunal electrodes and a duodenal cannula in three separate experiments to investigate the effects of IES on duodenal distension (DD)-induced delayed gastric emptying and discomfort signs, vagal efferent activity, and jejunal tone. We found that: (i) IES significantly accelerated gastric emptying of liquid delayed by distension (18.05 +/- 4.06%vs. 7.18 +/- 1.99%, P = 0.036 at 60 min). (ii) IES significantly reduced vomiting and discomfort/pain induced by distension. The average signs score was 15.33 +/- 1.37 during distension which decreased to 6.50 +/- 0.91 (P = 0.0002) with IES. (iii) IES did not change vagal afferent activity, which was assessed by the spectral analysis of the heart rate variability. (iv) IES decreased jejunal tone. In conclusion, IES with parameters commonly used in gastric electrical stimulation for nausea and vomiting associated with gastroparesis improves DD-induced delayed gastric emptying and prevents DD-induced vomiting and discomfort signs. Further studies are warranted to investigate the therapeutic potential of IES for gastrointestinal symptoms associated with disturbances in motility and sensory function in small intestine.

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“…Excitatory stimulation (i.e., pacing) is a well-known therapy for maintaining normal heart rate. It has been suggested that pacing of the stomach can ameliorate symptoms related to postpartial gastrectomy and gastroparesis (2,20,22). Moreover, unsynchronized pacing has been attempted in experimental animals and in morbid obesity in humans to reduce food intake (7,9).…”

mentioning

confidence: 99%

Enhancement of antral contractions and vagal afferent signaling with synchronized electrical stimulation

Peles¹,

Petersen²,

Aviv³

et al. 2003

American Journal of Physiology-Gastrointestinal and Liver Physi

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Gastric filling activates vagal afferents involved in peripheral signaling to the central nervous system (CNS) for food intake. It is not known whether these afferents linearly encode increasing contractions of the antrum during antral distension (AD). The aim of this study was to investigate effects of AD and electrically enhanced antral contractions on responses of vagal afferents innervating the antrum. Single-fiber recordings were made from the vagal afferents in anesthetized male Long-Evans rats. Antral contractions were measured with a solid-state probe placed in the antrum. A nonexcitatory electrical stimulation (NES) inducing no smooth muscle contractions was applied during the ascending phase of antral contractions to enhance subsequent antral contractions. Fifty-six fibers identified during AD (1 ml for 30 s) were studied through different types of mechanical stimuli. Under normal conditions, one group of fibers exhibited rhythmic firing in phase with antral contractions. Another group of fibers had nonrhythmic spontaneous firing. Responses of 15 fibers were tested with NES during multiple-step distension (MSD). NES produced a mean increase in antral contraction amplitude (177.1 +/- 35.3%) and vagal afferent firing (21.6 +/- 2.6%). Results show that both passive distension and enhanced antral contractions activate distension-sensitive vagal afferents. Responses of these fibers increase linearly to enhanced antral contraction induced by NES or MSD up to a distending volume of 0.6 ml. However, responses reached a plateau at a distending volume >0.8 ml. We concluded that enhanced contraction of the antrum can activate vagal afferents signaling to the CNS.

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Intestinal Pacing for Canine Postgastrectomy Dumping

Cited by 30 publications

References 7 publications

Effects of vasopressin and long pulse–low frequency gastric electrical stimulation on gastric emptying, gastric and intestinal myoelectrical activity and symptoms in dogs

Effects of vasopressin and long pulse–low frequency gastric electrical stimulation on gastric emptying, gastric and intestinal myoelectrical activity and symptoms in dogs

Intestinal electrical stimulation improves delayed gastric emptying and vomiting induced by duodenal distension in dogs

Enhancement of antral contractions and vagal afferent signaling with synchronized electrical stimulation

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