Intestinal Pacing for Intestinal Pseudo-Obstruction

DESCRIPTION (provided by applicant): Chronic idiopathic intestinal pseudo-obstruction (CIP) is a life-threatening disease without a cure. Severe postoperative ileus is common in patients after abdominal surgery and requires extensive hospitalization. Both diseases are characterized with delayed intestinal transit attributed to impaired intestinal motor functions. Currently, there is no cure for CIP; most patients rely on parenteral nutrition which is risky and extremely expensive. While postoperative ileus may resolve with time, it imposes a heavy burden on both patients and hospitals due to extensive hospitalization. The purpose of this project is to prove that these diseases can be treated with the novel methods of intestinal pacing proposed in this application. Further, we will prove that intestinal pacing for treating these diseases can be achieved using a conventional enteral feeding tube without any additional surgical procedures. Specific aims are to prove that the proposed method is able to electrically pace the small intestine, normalize intestinal electrical dysrhythmia, improve intestinal contractile activity and accelerate intestinal transit in a canine model. Preliminary studies have been performed, demonstrating the likelihood of success with the proposed method of intestinal pacing. A competitive team has been assembled including a veteran researcher in gastrointestinal motility and pacing, a surgeon with extensive surgical experience on the gastrointestinal tract and a computer scientist who has been working on gastrointestinal pacing for six years. Chronic intestinal pseudo-obstruction (CIP) is a life-threatening disease without a cure. Severe postoperative ileus (slow movement of the small bowel) is common in patients after abdominal surgery and requires extensive hospitalization. This project is proposed to develop an innovative method of small bowel electrical pacing for the treatment of these diseases. In this method electrical pacing is achieved via a pair of wires attached to a regular feeding tube placed in the small bowel. Feasibility of such a novel method will be tested in this Phase I project.