Effects and mechanisms of long-pulse gastric electrical stimulation on canine gastric tone and accommodation

Gastric electrical stimulation (GES) has been applied to treat gastroparesis and morbid obesity. The aims of this study were to evaluate the sites of stimulation and the mechanisms of GES on gastric tone and accommodation. Gastric tone and accommodation were evaluated with a barostat in surgically prepared dogs. GES was applied at seven different locations, and gastric tone was assessed at each site. The effect of truncal vagotomy on gastric tone and accommodation and the role of the nitrergic pathway were also evaluated. We have found: 1) GES induced varying degrees of gastric relaxation at all tested locations in normal dogs; 2) Gastric volume was also significantly increased with GES in vagotomized dogs and the change tended to be lower than that of normal animals; 3) Gastric accommodation was reduced during GES in both the normal and vagotomized dogs and the reduction tended to be more in the vagotomized animals; 4) The GES-induced increase in gastric volume was partially abolished by intravenous nitric oxide synthase inhibitor. GES at various sites of the stomach exerts inhibitory effect on gastric tone; the most effective sites are in the antrum along the lesser or greater curvature; the inhibitory effect of GES on gastric tone is partially mediated by the vagal and nitrergic pathway.