Electrical pacing accelerates intestinal transit slowed by fat-induced ileal brake

Previous studies on intestinal electrical stimulation were aimed at achieving a delay in intestinal transit. The aim of this study was to test the hypothesis that the physiological slowing of intestinal transit by the fat-induced ileal brake might be accelerated with intestinal electrical stimulation. This study was performed in five dogs prepared with eight serosal electrodes in the jejunum and two chronic intestinal fistulas located in the duodenum and at the midpoint of the small intestine. To slow transit by triggering the ileal brake, oleate was delivered into the distal half of the gut while buffer was perfused into the proximal half of the gut. Intestinal transit between the fistulas was measured by the recovery of [Tc-99m] DTPA. To test for the effect of pacing, transit was compared with vs. without continuous forward electrical stimulation (frequency: 24 cycles/min; pulse duration: 50 msec, pulse amplitude 1-3 mA). Electrical stimulation completely entrained intestinal pacesetter potentials as measured from the seven recording electrodes distal to the pacing electrode. A substantial and significant increase in intestinal transit was observed with intestinal electrical stimulation with the percentage of marker recovery increasing from 19.2 +/- 9.3% to 84.6 +/- 11.3% ( P < 0.01). In conclusion, intestinal electrical stimulation accelerates intestinal transit slowed by ileal brake.