Esophageal stimulation devices and methods
Systems for stimulating one or more esophageal muscle contractions are provided. The systems, which are designed to evoke esophageal motion to promote the downward movement of material, include an elongated member for placement in a patient's esophagus and at least one mechanical or electrical stimulator coupled to the elongated member. Methods for stimulating and contracting an esophageal muscle using electrodes and a generated signal sequence are also provided.
1. A method for generating a distally traveling synthetic esophageal motion comprising:
identifying a patient having suspended esophageal peristaltic motility;
placing, in an esophagus of the patient, an elongated member sized and configured for nasal or oral placement into the esophagus and a series of stimulators mounted or mountable on the elongated member, the series of stimulators including at least two longitudinally spaced electrodes, chargeable to opposite polarities, for stimulating a portion of the esophagus provided therebetween;
positioning the series of stimulators along an esophageal length between the LES and the UES of the esophagus, the series of stimulators configured to directly stimulate a series of portions of the esophagus within the esophageal length; and
generating a sequence of stimulating signals to the series of stimulators to evoke a plurality of local esophageal contractions to create a distally traveling synthetic esophageal motion along the esophageal length.
2. The method of claim 1 , wherein the local esophageal contractions are spasms.
3. The method of claim 1 , wherein the local esophageal contractions substantially close local segments of the esophagus lumen.
4. The method of claim 1 , wherein the local esophageal contractions develop local esophageal pressures of at least 50 mmHg.
5. The method of claim 1 , wherein the local esophageal contractions develop local esophageal pressures of at least 100 mmHg.
6. The method of claim 1 , wherein the generating a sequence of stimulating signals comprises generating at least two evoked contractions that are sequentially and/or timely generated according to a preset sequence.
7. The method of claim 1 , wherein the sequence of stimulating signals are generated by a generator sized and configured for prolonged intra-oral or intra-esophageal placement.
8. The method of claim 1 , wherein the elongated member is a medical intubation device.
9. The method of claim 8 , wherein the series of stimulators are spaced along the effective length of the medical intubation device.
10. The method of claim 8 , wherein the medical intubation device is a gastric feeding tube.
11. The method of claim 1 , wherein at least one of the series of stimulators is fixed to the elongated member.
12. The method of claim 1 , wherein the elongated member includes at least one sensor mounted or mountable on the elongated member.
13. The method of claim 12 , wherein at least one sensor is mounted on the elongated member distally to a distal-most stimulator.
14. The method of claim 12 , wherein a proximal-most sensor is positioned on the elongated member at least 5 cm distally to the distal-most stimulator.
15. The method of claim 12 , wherein the at least one sensor comprises at least one of: a pH sensor, a pressure sensor, a manometer, an impedance sensor, a motion sensor, a capacitance sensor, and a mechanical sensor.
16. The method of claim 1 , wherein the local esophageal contractions increase local pressures between the LES and the UES.
17. The method of claim 16 , wherein the increased local pressures diminish retrograde movement of material or chyme.
18. The method of claim 16 , wherein the increased local pressures force retrograded material to travel to a distal esophageal segment.
19. The method of claim 1 , wherein the series of stimulating signals are staggered in time such that distally-located stimulators receive stimulating signals after more proximally-located stimulators.
20. The method of claim 1 , wherein the series of stimulating signals includes at least one pulse or train comprising a magnitude higher than a stimulating threshold between 5V and 20V.
21. The method of claim 1 , wherein the series of stimulating signals includes a below-threshold pulse to induce the tissue to contact more firmly.
22. The method of claim 1 , wherein the series of stimulating signals induces at least one pulse to induce the tissue to contact more firmly.
23. The method of claim 1 , wherein the series of stimulators are configured to selectively transition between each of three states.
24. The method of claim 23 , wherein the three states are connected to a signal generator, connected to ground, and disconnected from the signal generator.
25. The method of claim 1 , wherein the signal sequence produces a wave of distally-progressing contractions within the esophagus.
26. The method of claim 25 , wherein the wave of contractions includes a second wave starting only after a first wave is finished with no overlapping.
27. The method of claim 25 , wherein the wave of contractions includes a second wave beginning before a first wave completes a travel from upper portion of the esophagus.