Noninvasive Vagal Nerve Stimulation for Gastroenterology Pain Disorders

Abstract

Abdominal pain continues to be a major challenge and unmet need in clinical practice. Normalization of bidirectional gut-brain signaling has generated much interest as a therapeutic approach to treat chronic abdominal pain. Vagal nerve stimulation (VNS) is emerging as a potential non-pharmacologic strategy for the treatment of abdominal pain. In this review paper, we will summarize the etiologies of chronic pain in gastrointestinal disorders and discuss the rational for VNS as a therapeutic approach to chronic abdominal pain, with particular emphasis in the gammaCore stimulator which allows for noninvasive VNS.

Lay abstract

Abdominal pain is still a major medical problem that needs more study and better treatment options. The connection between the gut and the brain is very important. This connection could reveal new therapies to treat abdominal pain. One such therapy is vagal nerve stimulation (VNS). VNS is showing promise for the treatment of abdominal pain and other conditions. In this review, we will summarize the causes of abdominal pain. We will also explain how VNS could work to treat abdominal pain, with particular emphasis in the gammaCore stimulator.

Keywords::

• central sensitization
• gammaCore^®
• vagal nerve stimulation
• visceral hypersensitivity

Author contributions

AG Blackmore, study concept, design and direction, manuscript writing and submission, has approved the final draft submitted; A Habtezion study concept and design, data interpretation and edited manuscript, has approved the final draft submitted; L Nguyen study concept and design, manuscript editing, has approved the final draft submitted.

Financial & competing interests disclosure

This article was made possible by an NIH grant: T32 NIDDK, grant/award number: 5T32DK007056-43 and a generous philanthropic gift from Colleen and RD Haas. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Company review disclosure

In addition to the peer-review process, with the author’s consent, the manufacturer of the product discussed in this article was given the opportunity to review the manuscript for factual accuracy. Changes were made by the author at their discretion and based on scientific or editorial merit only. The author maintained full control over the manuscript, including content, wording and conclusions.

Additional information

Funding

This article was made possible by an NIH grant: T32 NIDDK, grant/award number: 5T32DK007056-43 and a generous philanthropic gift from Colleen and RD Haas. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.