title: Gastric electrical stimulation is associated with improvement in pancreatic exocrine function in humans.
abstract: OBJECTIVE
  To define the possible effects of gastric electrical stimulation (GES) for gastroparesis on pancreatic function, we performed 2 related human studies.
  
  
  METHODS
  Fecal elastase values were compared in 2 patient groups: (1) GES devices ON and (2) GES devices OFF and (2) in 3 control groups: (1) no response (NR) to prokinetic medications, (2) positive response (RES) to medications, and (3) normal controls. Polypeptide levels in 7 of 9 GES patients with device ON and OFF, elastase results, GI symptoms (TSS), and heart rate variability (HRV) were compared by paired t tests and/or ANOVA and reported as mean +/- SE.
  
  
  RESULTS
  Elastase was different for GES-ON and OFF (508.0 +/- 92.2 vs. GES-OFF 378.6 +/- 87.4, P < 0.05). Elastase was lower in medication NR and RES than in normal controls. Postprandial pancreatic polypeptide was greater with GES ON than OFF (P = 0.07). HRV revealed a lower percentage of change with device ON versus OFF (44.2 +/- 5.5 vs. 48.5 +/- 5.2, P = 0.08) and lower TSS with ON versus OFF (15.9 +/- 4.5 vs. 25.7 +/- 5.3, P < 0.05).
  
  
  CONCLUSIONS
  GES improves exocrine pancreatic release, effects autonomic control, and improves GI symptoms, suggesting a possible role for GES in the treatment of pancreatic insufficiency associated with gastroparesis.
authors.affiliation: University of Tennessee, Memphis, Tennessee, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Luo
authors.forename: Amar
authors.initials: A
authors.lastname: Al-Juburi
authors.forename: Hani
authors.initials: H
authors.lastname: Rashed
authors.forename: Thomas
authors.initials: T
authors.lastname: O'Dorisio
authors.forename: Benoit
authors.initials: B
authors.lastname: Marchal
authors.forename: Warren
authors.initials: W
authors.lastname: Starkebaum
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Abell
mesh_terms: D004351:Drug Resistance; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D010188:Exocrine Pancreatic Insufficiency / Q000097:blood / Q000209:etiology / Q000628:therapy*; D005215:Fasting; D005243:Feces / Q000201:enzymology; D005260:Female; D018589:Gastroparesis / Q000150:complications / Q000628:therapy*; D006339:Heart Rate; D006801:Humans; D008297:Male; D046790:Pancreas, Exocrine / Q000503:physiopathology*; D010196:Pancreatic Elastase / Q000032:analysis; D010191:Pancreatic Polypeptide / Q000097:blood*; D019518:Postprandial Period
chemical_list: D010191:Pancreatic Polypeptide; D010196:Pancreatic Elastase