Pyloric electrical stimulation reduces food intake by inhibiting gastric motility in dogs.

BACKGROUND & AIMS The pylorus plays an important role in regulating gastric emptying. The aim of this study was to investigate the therapeutic potential of pyloric electrical stimulation (PES) for obesity in dogs. METHODS The study was composed of 3 separate experiments. The first experiment was designed to study the effects of PES with various parameters on gastric emptying and gastric slow waves in 5 sessions. The second experiment was used to test the effects of PES on antral contractions. The acute effect of PES on food intake was studied in the third experiment. RESULTS (1) Pyloric myoelectrical recording showed dual frequencies. The lower frequency was identical to the frequency of the gastric slow waves, and the higher frequency was similar to that of the intestinal slow waves. (2) Gastric emptying was significantly delayed with PES, and the delay in gastric emptying was significantly and negatively correlated with stimulation energy ( r = -.673; P < .001). (3) PES significantly impaired the regularity and coupling of the intrinsic gastric myoelectrical activity in an energy-dependent manner. The delayed gastric emptying was significantly correlated with the impairment of the coupling of gastric myoelectrical activity ( r = .441; P < .02). (4) Antral contractions on the fed state were significantly and substantially inhibited with PES. (5) Acute PES significantly reduced food intake. CONCLUSIONS PES reduces food intake that may be attributed to its inhibitory effects on intrinsic gastric myoelectrical activity, antral contractions, and gastric emptying.

[1]  B. Schirmer,et al.  Effects of pacing parameters on entrainment of gastric slow waves in patients with gastroparesis. , 1998, American journal of physiology. Gastrointestinal and liver physiology.

[2]  O. L. Updike,et al.  Acceleration of gastric emptying with electrical stimulation in a canine model of gastroparesis. , 1992, The American journal of physiology.

[3]  B. Miedema,et al.  Pacing the human stomach. , 1990, Surgery.

[4]  R A Ross,et al.  Gastric pacing improves emptying and symptoms in patients with gastroparesis. , 1998, Gastroenterology.

[5]  Xiaohong Xu,et al.  Anti-Dysrhythmic Effects of Long-Pulse Gastric Electrical Stimulation in Dogs , 2004, Digestion.

[6]  Shiriki K. Kumanyika,et al.  Gastrointestinal surgery for severe obesity , 1991 .

[7]  Jieyun Yin,et al.  Gastric electrical stimulation with short pulses reduces vomiting but not dysrhythmias in dogs. , 2003, Gastroenterology.

[8]  J Chen,et al.  Gastric slow wave abnormalities in patients with gastroparesis. , 1992, The American journal of gastroenterology.

[9]  D. Booth,et al.  Obesity, overeating, and rapid gastric emptying in rats with ventromedial hypothalamic lesions. , 1986, Science.

[10]  J. Chen,et al.  Normalization of atropine-induced postprandial dysrhythmias with gastric pacing. , 1999, American journal of physiology. Gastrointestinal and liver physiology.

[11]  S. Krinsky,et al.  Gastric emptying and obesity , 1983 .

[12]  T. Powley,et al.  Gastric volume rather than nutrient content inhibits food intake. , 1996, The American journal of physiology.

[13]  G A Colditz,et al.  Economic costs of obesity. , 1992, The American journal of clinical nutrition.

[14]  C. Malbert,et al.  Gastroduodenal motor activity associated with gastric emptying rate in sheep. , 1988, The Journal of physiology.

[15]  J. Dent,et al.  Relationship of the motor activity of the antrum, pylorus, and duodenum to gastric emptying of a solid-liquid mixed meal. , 1988, Gastroenterology.

[16]  L. F. Martin,et al.  Severe obesity: expensive to society, frustrating to treat, but important to confront. , 1995, Southern medical journal.

[17]  E. Tinóis,et al.  Gastric Emptying and Intragastric Distribution of a Solid Meal in Functional Dyspepsia: Influence of Gender and Anxiety , 2004, Journal of clinical gastroenterology.

[18]  K. Kelly,et al.  Effects of gastric pacing on canine gastric motility and emptying. , 1993, The American journal of physiology.

[19]  J Toouli,et al.  Motor activity of the gastric antrum, pylorus, and duodenum under fasted conditions and after a liquid meal. , 1988, Gastroenterology.

[20]  V. Cigaina Gastric Pacing as Therapy for Morbid Obesity: Preliminary Results , 2002, Obesity surgery.

[21]  A. Zinsmeister,et al.  Relation between antral motility and gastric emptying of solids and liquids in humans. , 1985, The American journal of physiology.

[22]  J. Dent,et al.  Pyloric motor function during emptying of a liquid meal from the stomach in the conscious pig. , 1990, The Journal of physiology.

[23]  S. Sarna,et al.  Regulation of gastroduodenal emptying of solids by gastropyloroduodenal contractions. , 1993, The American journal of physiology.

[24]  A. Hoes,et al.  Disturbed Solid-Phase Gastric Emptying in Functional Dyspepsia (A Meta-Analysis) , 1998, Digestive Diseases and Sciences.

[25]  Z. Lin,et al.  Gastric pacing is a new surgical treatment for gastroparesis. , 2001, American journal of surgery.

[26]  T. Abell,et al.  Gastric electrical stimulation for gastroparesis: A multi-center double blind cross over study, by the wavess study group , 2000 .

[27]  K. Sanders,et al.  Role of nitric oxide as an inhibitory neurotransmitter in the canine pyloric sphincter. , 1993, The American journal of physiology.

[28]  S. Ischia,et al.  Long-term Effects of Gastric Pacing to Reduce Feed Intake in Swine , 1996, Obesity surgery.

[29]  Xiaohong Xu,et al.  Is There a One-to-One Correlation Between Gastric Emptying of Liquids and Gastric Myoelectrical or Motor Activity in Dogs? , 2002, Digestive Diseases and Sciences.

[30]  Xuemei Lin,et al.  Entrainment of Segmental Small Intestinal Slow Waves with Electrical Stimulation in Dogs , 2000, Digestive Diseases and Sciences.

[31]  G A Colditz,et al.  Current estimates of the economic cost of obesity in the United States. , 1998, Obesity research.

[32]  J. Chen,et al.  Abnormal gastric slow waves in patients with functional dyspepsia assessed by multichannel electrogastrography. , 2001, American journal of physiology. Gastrointestinal and liver physiology.

[33]  J. Chen,et al.  Clinical applications of electrogastrography. , 1993, The American journal of gastroenterology.