Non-invasive neuromodulation: an emerging intervention for visceral pain in gastrointestinal disorders


Author: Md Jahangir Alam1, Jiande D Z Chen2

Affiliation: <sup>1</sup> Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA. mdalam@med.umich.edu.

<sup>2</sup> Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, 48109, USA. cjiande@med.umich.edu.
Conference/Journal: Bioelectron Med
Date published: 2023 Nov 22
Other:
 Volume ID: 9   ,  Issue ID: 1   ,  Pages: 27   ,  Special Notes: doi: 10.1186/s42234-023-00130-5.   ,  Word Count: 240  
    Gastrointestinal (GI) disorders, which extend from the esophagus to the anus, are the most common diseases of the GI tract. Among these disorders, pain, encompassing both abdominal and visceral pain, is a predominant feature, affecting the patients' quality of life and imposing a substantial financial burden on society. Pain signals originating from the gut intricately shape brain dynamics. In response, the brain sends appropriate descending signals to respond to pain through neuronal inhibition. However, due to the heterogeneous nature of the disease and its limited pathophysiological understanding, treatment options are minimal and often controversial. Consequently, many patients with GI disorders use complementary and alternative therapies such as neuromodulation to treat visceral pain. Neuromodulation intervenes in the central, peripheral, or autonomic nervous system by alternating or modulating nerve activity using electrical, electromagnetic, chemical, or optogenetic methodologies. Here, we review a few emerging noninvasive neuromodulation approaches with promising potential for alleviating pain associated with functional dyspepsia, gastroparesis, irritable bowel syndrome, inflammatory bowel disease, and non-cardiac chest pain. Moreover, we address critical aspects, including the efficacy, safety, and feasibility of these noninvasive neuromodulation methods, elucidate their mechanisms of action, and outline future research directions. In conclusion, the emerging field of noninvasive neuromodulation appears as a viable alternative therapeutic avenue for effectively managing visceral pain in GI disorders.



Keywords: Abdominal pain; Acupuncture; Bioelectronic medicine; Gastrointestinal disorders; Noninvasive neuromodulation; Transcutaneous auricular vagus nerve stimulation; Transcutaneous electrical acustimulation.



PMID: 37990288 PMCID: PMC10664460 DOI: 10.1186/s42234-023-00130-5