Gastric electrical stimulation is associated with improvement in pancreatic exocrine function in humans.
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.
Luo
Jean
J
University of Tennessee, Memphis, Tennessee, USA.
Al-Juburi
Amar
A
Rashed
Hani
H
O'Dorisio
Thomas
T
Marchal
Benoit
B
Starkebaum
Warren
W
Abell
Thomas L
TL
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
D010191:Pancreatic Polypeptide; D010196:Pancreatic Elastase