Successful Treatment of Esophageal Dysmotility and Raynaud's Phenomenon in Systemic Sclerosis and Achalasia by Transcutaneous Nerve Stimulation: Increase in Plasma VIP Concentration

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Abstract
Dysphagia has been successfully treated by low-frequency transcutaneous nerve stimulation (TNS) in two patients with achalasia and in six patients with systemic sclerosis. A 30- to 45-min stimulation session was followed by augmentation of peristalsis in the lower half of the esophagus and relaxation of the gastroesophageal sphincter, with relief of dysphagia. The sclerotic patients were also relieved of invaliding Raynaud's phenomenon. One 30-min daily stimulation session, and later one session every 2nd or 3rd day, was sufficient to prevent relapse. After months or years of TNS treatment the stimulation could in three patients be withdrawn with no recurrence. A stimulation session produced about 30% increase in plasma vasoactive intestinal polypeptides. Activation of this neurornodulator is considered to be the cause of the beneficial effects on dysphagia and Raynaud's phenomenon.