Trends in Pharmacological Sciences

Electroceuticals in the Gastrointestinal Tract

DOI: https://doi.org/10.1016/j.tips.2020.09.014

Abstract

Electrical stimulation of the gastrointestinal (GI) tract through implanted stimulators can modulate motility, hormone release, and neural signaling. Studies show that electrical stimulation of GI tissue and nerves can be an effective therapy for several conditions including gastroesophageal reflux disease, gastroparesis, inflammatory bowel disease, and fecal incontinence. Varying electrical stimulation parameters and placement can have a significant impact on treatment efficacy. Ingestible electrotherapies that target specific sections and tissues along the GI tract hold significant potential for the treatment of GI, immune, neurologic, and endocrine disorders. The field of electroceuticals has attracted considerable attention over the past few decades as a novel therapeutic modality. The gastrointestinal (GI) tract (GIT) holds significant potential as a target for electroceuticals as the intersection of neural, endocrine, and immune systems. We review recent developments in electrical stimulation of various portions of the GIT (including esophagus, stomach, and small and large intestine) and nerves projecting to the GIT and supportive organs. This has been tested with varying degrees of success for several dysmotility, inflammatory, hormonal, and neurologic disorders. We outline a vision for the future of GI electroceuticals, building on advances in mechanistic understanding of GI physiology coupled with novel ingestible technologies. The next wave of electroceutical therapies will be minimally invasive and more targeted than current approaches, making them an indispensable tool in the clinical armamentarium.