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gastric electrical stimulation: An emerging therapy for children with intractable gastroparesis

World Journal of Gastroenterology 2019年第48期25卷 6880-6889页

作者： Aniruddh Setya Priyanka Nair Sam Xianjun Cheng Department of Pediatric Gastroenterology Hepatology and Nutrition University of Florida

Management of gastroparesis remains challenging,particularly in pediatric patients.Supportive care and pharmacological therapies for symptoms remain the mainstay treatment.Although they are effective for mild and some moderately severe cases,often time they do not work for severe gastroparesis.There are a few prokinetics available,yet the use of these drugs is limited by a lack of persistent efficacy and/or safety concerns.Currently,the only modality for adult patients with severe intractable gastroparesis is surgery,e.g.,pyloroplasty and partial gastrectomy,however,this option is generally considered too radical for a growing child.Novel therapeutic approaches,particularly those which are less invasive,are needed.This article explores gastric electrical stimulation(GES),a new therapy for gastroparesis.Unlike others,it neither needs medications nor gastrectomy;rather,it treats through the use of microelectrodes to deliver high-frequency low energy electric stimulation to the pacemaker area of the stomach.Thus,it is tolerated and safe in children.Like in adult patients,GES appears to work in releasing symptoms,improving nutrition,and enhancing the quality of life;it also helps wean off medications and eliminate many needs for hospitalization.Considering the transient nature of gastroparesis in children in many occasions,GES is considered a“bridging”therapy after failed medical interventions and before surgery.

关键词： Gastroparesis gastric electrical stimulation Nausea Vomiting Prokinetics

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Gastroparesis:New insights into an old disease

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World Journal of Gastroenterology 2020年第19期26卷 2333-2348页

作者： Paolo Usai-Satta Massimo Bellini Olivia Morelli Francesca Geri Mariantonia Lai Gabrio Bassotti Department of Internal Medicine Division of GastroenterologyBrotzu HospitalCagliari 09124Italy Gastrointestinal Unit Department of Translational Research and New Technologies in Medicine and SurgeryUniversity of PisaPisa 56122Italy Gastroenterology and Hepatology Section Department of MedicineUniversity of Perugia Medical SchoolPerugia 06123Italy Gastroenterology Unit University of CagliariMonserrato 09042Italy

Gastroparesis(Gp)is a chronic disease characterized by a delayed gastric emptying in the absence of mechanical obstruction.Although this condition has been reported in the literature since the mid-1900s,only recently has there been renewed clinical and scientific interest in this disease,which has a potentially great impact on the quality of life.The aim of this review is to explore the pathophysiological,diagnostic and therapeutical aspects of Gp according to the most recent evidence.A comprehensive online search for Gp was carried out using MEDLINE and EMBASE.Gp is the result of neuromuscular abnormalities of the gastric motor function.There is evidence that patients with idiopathic and diabetic Gp may display a reduction in nitrergic inhibitory neurons and in interstitial cells of Cajal and/or telocytes.As regards diagnostic approach,99-Technetium scintigraphy is currently considered to be the gold standard for Gp.Its limits are a lack of standardization and a mild risk of radiation exposure.The C13 breath testing is a valid and safe alternative method.13C acid octanoic and the 13C Spirulina platensis recently approved by the Food and Drug Administration are the most commonly used diagnostic kits.The wireless motility capsule is a promising technique,but its use is limited by costs and scarce availability in many countries.Finally,therapeutic strategies are related to the clinical severity of Gp.In mild and moderate Gp,dietary modification and prokinetic agents are generally sufficient.Metoclopramide is the only drug approved by the Food and Drug Administration for Gp.However,other older and new prokinetics and antiemetics can be considered.As a second-line therapy,tricyclic antidepressants and cannabinoids have been proposed.In severe cases the normal nutritional approach can be compromised and artificial nutrition may be needed.In drug-unresponsive Gp patients some alternative strategies(endoscopic,electric stimulation or surgery)are available.

关键词： Gastroparesis Delayed gastric emptying gastric Scintigraphy 13C breath testing Wireless motility capsule Prokinetics Antiemetic drugs gastric-per-oral endoscopic myotomy gastric electrical stimulation

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Electrogastrogram Recovery for Correction of gastric Disorders Using gastric Stimulator

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Circuits and Systems 2016年第4期7卷 179-186页

作者： Govindasamy Gopu M. S. GeethaDevasena Department Biomedical Engineering Sri Ramakrishna Engineering College Coimbatore India Department Computer Science Engineering Sri Ramakrishna Engineering College Coimbatore India

gastric disorders play an important role in digestive system of a human subject. gastric disorder is due to the gastric dysmotility due to delayed gastric emptying and other motor dysfunctions like impaired fundic distention. Nowadays invasive technique like laparoscopy procedure, endoscopy procedure and surgery procedure plays a vital role in investigation of gastric disorders. Electrogastrogram is a noninvasive technique for analyzing digestive system disorders. In this proposed work, stimulation is delivered with the electrode package with camera, which travels through an esophagus to reach stomach and stimulate the interstitial cajal cells. Due to this stimulation the stomach starts, its activity a potential is provided that is recorded with electrode setup, which is called electrogastrogram. It is verified with its normal range 3 cpm. The stimulation includes pulses mode and continuous mode. Stomach function is recovered and its frequency is measured and the same is compared with normal range value. Depending upon the subject condition, the gastric activity is improved by setting different values of duty cycle. By this procedure the subject avoid painful procedure, stay in hospital, frequently and the cost is minimum.

关键词： Gastroparesis Nausea Vomiting LabVIEW Electro GastroGram gastric electrical stimulation Duty Cycle PIC Microcontroller

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