Document Detail


The Effect of Electrical Stimulation of the Lower Esophageal Sphincter (LES) on LES Pressure in a canine model.
MedLine Citation:
PMID:  18583461     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Gastric electrical stimulation (GES) modulates lower esophageal sphincter pressure (LESP). High-frequency neural stimulation (NES) can induce gut smooth muscle contractions. To determine if lower esophageal sphincter (LES) electrical stimulation (ES) can affect LESP, bipolar electrodes were implanted in the LES of four dogs. Esophageal manometry during sham or ES, was performed randomly on separate days. Four stimuli were used: 1) Low frequency, 350msec pulses at 6 cycles/min; 2) High-frequency-1: 1msec pulses at 50Hz; 3) High-frequency-2: 1msec pulses at 20Hz; and 4) NES: 20msec bipolar pulses at 50Hz. Recordings were obtained postprandially. Tests consisted of three 20-minute periods: baseline, stimulation/sham and post-stimulation. The effect of NES was tested under anesthesia and following IV administration of L-NAME and atropine. Area under the curve (AUC) and LESP were compared among the 3 periods, using ANOVA and t-test, p<0.05. Data are shown as mean+/-SD. We found that low-frequency stimulation caused a sustained increase in LESP: 32.1+/-12.9 (pre-stimulation) vs. 43.2+/-18.0 (stimulation) vs. 50.1+/-23.8 (post-stimulation), p<0.05. AUC significantly increased during and after stimulation. There were no significant changes with other types of ES. With NES, LESP initially rose and then decreased below baseline (LES relaxation). During NES, L-NAME increased both resting LESP and the initial rise in LESP, and markedly diminished the relaxation. Atropine lowered resting LESP and abolished the initial rise in LESP. In conclusion, low frequency ES of the LES increases LESP in conscious dogs. NES has dual effect on LESP: an initial stimulation, cholinergically mediated, followed by relaxation mediated by nitric oxide. Key words: Electrical stimulation, LES pressure, Nitric, Cholinergic, GERD.
Authors:
Claudia P Sanmiguel; Masanobu Hagiike; Martin P Mintchev; Ryan Dela Cruz; Edward H Phillips; Scott A Cunneen; Jeffrey L Conklin; Edy E Soffer
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2008-6-26
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  -     ISSN:  1522-1547     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-6-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Cedars Sinai Medical Center.
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