Reverse electrical pacing improves intestinal absorption and transit time

This study evaluates the effect of reverse electrical pacing on intestinal absorption and transit time in an enterostomy model. Twenty-five male Sprague-Dawley rats (148 to 208 gm) underwent division and anastomosis of the proximal jejunum to eliminate the proximal gastroduodenal pacemaker. A 30.0 cm loop ileostomy was formed, and leads were placed at 1.0 and 3.0 cm proximal to the stoma. Reverse pacing was done with a 0.25 Hz, 50 msec pulse at 0.1 mA. Transit time was evaluated with 1.0 ml barium gavage and was 12 ± 4 minutes in group I controls (n = 13) versus 27 ± 21 minutes in group II (n = 12) reverse-paced rats (p < 0.025). D-xylose absorption was determined in 18 rats. Levels were 14.0 ± 3.6 mg/dl in control rats (n = 6) and 15.5 ± 3.4 mg/dl in reverse-paced rats (n = 6). Increasing the pulse milliamperage to 2.0 mA (n = 6) increased D-xylose serum levels to 38.8 ± 27.7 mg/dl (p < 0.05). Transit rate and net water flux were determined in eight additional rats with 15 cm Theiry-Vella loops. Transit rate was measured with 0.2 ml of methylene blue and was 3.00 ± 2.32 ml/min in unpaced rats compared with 9.95 ± 0.71 ml/min with reverse pacing (p < 0.025). Water flux studies showed that control rats had a net secretory loss of 0.20 ± 0.48 ml/cm while paced rats absorbed 0.08 ± 0.12 ml/cm. These data indicate that reverse electrical pacing increases transit time and nutrient and fluid absorption. These observations suggest that reverse electrical pacing may be a useful adjunct in instances of short gut associated with an enterostomy.