Ameliorating Effect of Transcutaneous Electroacupuncture on Impaired Gastric Accommodation in Patients with Postprandial Distress Syndrome-Predominant Functional Dyspepsia: A Pilot Study

Patients with functional dyspepsia (FD) have both reduced gastric accommodation and impaired gastric motility that are difficult to treat. The aim of this study was to investigate the therapeutic potential of transcutaneous electroacupuncture (TEA) for both of these disorders in FD patients. Acute experiments were performed in FD patients to study the effect of TEA and sham-TEA on gastric accommodation assessed by a nutrient drink test and gastric motility assessed by the measurement of the electrogastrogram (EGG). TEA or sham-TEA was performed via cutaneous electrodes at acupoints ST36 and PC6 or sham-points nonacupoints. It was found that (1) gastric accommodation (maximum tolerable volume) was reduced in FD patients compared with the controlsP<0.03. TEA improved gastric accommodation in FD patientsP<0.02. (2) Acute TEA significantly increased the percentage and power of normal gastric slow waves in the fed state assessed in the FD patients by the EGG in comparison with sham-TEA. (3) TEA increased vagal activity assessed by the spectral analysis of the heart rate variability in the fed state in FD patients. It was concluded that needleless method of transcutaneous electroacupuncture may have a therapeutic potential for treating both impaired gastric accommodation and impaired gastric motility in patients with FD.

Intestinal Motility after Ileal Pouch-Anal Anastomosis

Colectomy, mucosal proctectomy and ileal pouch-anal anastomosis, has become the procedure of choice for carefully selected patients with ulcerative colitis requiring surgery. Pathophysiological studies after the operation have led to a better understanding of the mechanisms of continence and to the development of new technology to study anorectal function. Manometric studies of the anal sphincter, ileal pouch and distal ileum have shown that the operation alters the mechanisms of continence. The maximal tolerable volume of distension of an ileal pouch often approximates that of a normal rectum and yet the functional outcome may differ from a well functioning ileorectal anastomosis. Many other factors influence the result of the operation. The influence of the pattern of motility of the proximal and distal small bowel has been evaluated. The ileal pouch accommodation to distension has been correlated to clinical outcome. Scintigraphic techniques were designed to study the relationship between motility, filling and emptying of the ileal reservoirs. Measures designed to slow intestinal transit, increase absorption and reduce stool output are under investigation.