Gi tract stimulation devices and methods

Abstract

Systems, methods and devices, for stimulating one or more esophageal muscle contractions are provided. The system, methods, and devices may be designed to evoke motion and/or restore function in one or more organs that are located distal to the lower esophageal sphincter. A controller and a generator may be used to transmit signals to one or more electrodes in a tube placed in a patient's GI tract. In some aspect, the generator is configures to generate a series of pulses for one or more periods of time. In some aspects, a preliminary pulse is transmitted to narrow and esophageal portion such that an esophageal wall is in contact with at least one electrode thus lowering the nominal stimulation threshold.

1 - 57 . (canceled) 
     
     
         58 . A system for evoking motility in a target muscle located remote from the esophagus, from within the esophagus, in a subject, the system comprising:
 a member configured for positioning at least one electrode pair in the esophagus, each said electrode pair includes a first electrode electrically connectable to a signal generator and a second electrode electrically connectable to a grounding site; and   a controller programmed to activate said signal generator to repeatedly apply an electrically induced signal sequence to said electrode pair;   wherein, when said first electrode is positioned adjacent to a respective first portion of said esophageal muscle and said second electrode is positioned adjacent to a respective second portion of said esophageal muscle, and when said signal sequence is applied to said electrode pair, the system is configured to cause repeated local contractions of said esophageal muscle, between said respective first and respective second portions of said esophageal muscle, until consequently evoking motility in the target muscle.   
     
     
         59 . A system according to  claim 58 , wherein said member is configured to prevent positioning of said electrode pair distally to an LES in the esophagus. 
     
     
         60 . A system according to  claim 58 , wherein said member is sized for extending along the esophagus with a plurality of said electrode pair distributed along a length thereof. 
     
     
         61 . A system according to  claim 58 , wherein said controller is programmed to generate a first signal to evoke local muscle contraction at a first of said electrode pair, and, following a predetermined period, to generate a second signal to evoke local muscle contraction at a second of said electrode pair positioned distally to said first electrode pair. 
     
     
         62 . A system according to  claim 61 , wherein said predetermined period is between 0.1 second and 2 seconds. 
     
     
         63 . A system according to  claim 58 , wherein said controller is programmed to repeat said signal sequence during at least 15 minutes. 
     
     
         64 . A system according to  claim 58 , wherein each said signal sequence is configured to stimulate said esophageal muscle during 2 seconds to 20 seconds. 
     
     
         65 . A system according to  claim 58 , wherein said series of local contractions form distally progressing esophageal contractions. 
     
     
         66 . A system according to  claim 58 , wherein said target muscle is located in abdomen of the subject. 
     
     
         67 . A system according to  claim 58 , wherein said target muscle is located in stomach, small intestine, and/or large intestine of the subject. 
     
     
         68 . A system according to  claim 58 , wherein said controller is programmed to activate said signal generator in accordance with a chosen GI tract activation regime having a number of GI tract activating sessions, each including at least one signal sequence, wherein each said activating sessions includes a plurality of signal sequences with sequence intermission between each two adjacent signal sequences. 
     
     
         69 . A system according to  claim 68  wherein a total duration of a single sequence cycle, consisting of a signal sequence and a following sequence intermission, is between 0.5 minute and 5 minutes. 
     
     
         70 . A system according to  claim 68 , wherein said GI tract activation regime and said sessions are programmed such that sequence cycles during patient feeding are shorter than sequence cycles in between feedings, or/and such that sequence cycles at night time are shorter than sequence cycles at day time. 
     
     
         71 . A system according to  claim 58 , wherein said signal sequence includes a plurality of pulses, wherein said plurality of pulses is applied in a frequency greater than 5 Hz with a pulse width between 1 millisecond and 20 milliseconds. 
     
     
         72 . A system according to  claim 58 , wherein said signal sequence includes a plurality of pulse trains, wherein an intermission between two pulse trains in a single signal sequence is between 0 and 2 seconds, and/or wherein the number of said pulse trains is equal or higher than the number of electrodes of same designated polarity in use for applying said pulse trains. 
     
     
         73 . A system according to  claim 58 , further comprising a measuring unit configured for measuring a local condition in direct contact with and/or adjacent said electrode pair. 
     
     
         74 . A system according to  claim 73 , wherein said local condition includes local impedance indicative of an esophageal muscle tissue. 
     
     
         75 . A system according to  claim 73 , wherein said controller is configured to activate said signal generator only when measured local impedance is below 2,000 ohms. 
     
     
         76 . A method for evoking motility in a target muscle located remote from the esophagus, from within the esophagus, in a subject, the method comprising:
 positioning at least one electrode pair in the esophagus;   placing a first electrode of said electrode pair adjacent to a respective first portion of an esophageal muscle and electrically connecting said first electrode to a signal generator;   placing a second electrode of said electrode pair adjacent to a respective second portion of said esophageal muscle and electrically connecting said second electrode to a grounding site;   applying said signal generator to generate an electrically induced signal sequence to said electrode pair, thereby causing repeated local contractions of said esophageal muscle, between said respective first and respective second portions of said esophageal muscle, until evoking motility in the target muscle resulting from said repeated esophageal muscle contractions.   
     
     
         77 . A method according to  claim 76 , wherein said target muscle is located in abdomen of the subject.