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Other Gastrointestinal Testing and Therapeutic Procedures

By

Jonathan Gotfried

, MD, Lewis Katz School of Medicine at Temple University

Reviewed/Revised Mar 2023
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Breath tests

Wireless motility capsule

Wireless motility capsule involves an ingestible device that continuously measures the pressure and pH of the intraluminal environment as the device travels through the gastrointestinal tract. It is used to measure transit time, pressure profile, and motility of the entire gastrointestinal tract and of individual regions (stomach, small intestine, colon). This device can help assess gastric emptying as well as small-bowel and colonic transit in patients presenting with symptoms suggestive of dysmotility.

Neuromodulation/neurostimulation

Electrical stimulation of gastrointestinal nerves can be used to treat a variety of gastrointestinal disorders of motility.

Low parasympathetic tone is thought to be the cause of gastrointestinal dysmotility. Neuromodulation increases parasympathetic tone thereby improving peristalsis and gastrointestinal transit of food and gas. Furthermore, neuromodulation may affect visceral and central pain pathways thereby targeting some of the pathophysiologic mechanisms believed to cause disorders such as irritable bowel syndrome (IBS).

Gastric electrical stimulation has been used in patients with diabetic or idiopathic gastroparesis for the treatment of refractory symptoms, particularly nausea and vomiting. Gastric electrical stimulation is achieved through the surgical placement of electrical nodes into the stomach. Use of gastric electrical stimulation is not widespread and is only available at specialized centers for select patients.

Sacral stimulators are used to treat fecal incontinence Fecal Incontinence Fecal incontinence is involuntary defecation. Diagnosis is clinical. Treatment is a bowel management program and perineal exercises, but sometimes colostomy is needed. (See also Evaluation of... read more . Stimulation of the sacral nerve increases rectal tone and results in fewer episodes of incontinence. Sacral stimulators are initially placed externally to determine efficacy and then implanted through a minimally invasive procedure, typically by a surgeon.

Vagus nerve stimulation, acupuncture, and, more recently, transcutaneous electrical neural stimulation are being explored to treat various gastrointestinal conditions, including IBS with constipation.

Drugs Mentioned In This Article

Drug Name Select Trade
Aluvea , BP-50% Urea , BP-K50, Carmol, CEM-Urea, Cerovel, DermacinRx Urea, Epimide-50, Gord Urea, Gordons Urea, Hydro 35 , Hydro 40, Kerafoam, Kerafoam 42, Keralac, Keralac Nailstik, Keratol, Keratol Plus, Kerol, Kerol AD, Kerol ZX, Latrix, Mectalyte, Nutraplus, RE Urea 40, RE Urea 50 , Rea Lo, Remeven, RE-U40, RYNODERM , U40, U-Kera, Ultra Mide 25, Ultralytic-2, Umecta, Umecta Nail Film, URALISS, Uramaxin , Uramaxin GT, Urea, Ureacin-10, Ureacin-20, Urealac , Ureaphil, Uredeb, URE-K , Uremez-40, Ure-Na, Uresol, Utopic, Vanamide, Xurea, X-VIATE
Acilac, Cephulac, Cholac, Chronulac, Constilac, Constulose, Enulose, Generlac, Kristalose
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