Kids who suffer from gastrointestinal illnesses may get relief through ear, study finds

Young people who suffer from two serious gastrointestinal illnesses may find relief from a noninvasive treatment that stimulates the vagus nerve through their ear, according to a new Long Island-based study published Wednesday.

A pilot clinical trial conducted by the Feinstein Institutes for Medical Research in Manhasset found more than 64% of participants with mild to moderate Crohn's disease or ulcerative colitis who had vagus nerve stimulation experienced reduced inflammation.

In addition, about one-third of the patients with ulcerative colitis and about half of the patients with Crohn’s disease had no symptoms by the end of the 16-week study.

The results were published in the journal Bioelectronic Medicine.

Dr. Benjamin Sahn, the lead researcher on the study and instructor at Feinstein's Institute of Bioelectric Medicine, said finding alternative therapies for these chronic diseases is key. Some medicines to treat symptoms can weaken the immune system of young patients.

About 1.6 million people in the U.S. have inflammatory bowel disease, according to the Crohn's and Colitis Foundation. It’s estimated about 80,000 of them are children.

“If any number of kids can benefit from a non-medication based, nonimmune suppressive, minimal-to-no-risk therapy, it's a home run, especially in pediatrics,” said Sahn, who is also a pediatric gastroenterologist at Cohen Children's Medical Center.

The vagus nerves run from the brain down to the chest and stomach, helping control vital functions such as heart rate, breathing and digestion.

The treatment involves placing a noninvasive probe, similar to an earbud, in a person’s left ear attached to an electronic device.

“By delivering very small amounts of electrical impulses through the probe, we can activate the vagus nerve and send signals into the body,” he said

The nerve then sends signals from the brain and releases chemicals that can cut down on inflammation.

Vagus nerve stimulation for seizures, migraines

Scientists have researched stimulation of the vagus nerve since the late 1800s, when neurologist James Corning explored it as a way to prevent seizures. In recent years, the U.S. Food and Drug Administration has approved vagus nerve stimulation devices designed to help control seizures and migraines, as well as to treat depression and recovery from strokes. Some of those devices required the patient to have an implant placed in their neck.

Current research has focused on how it can help with chronic inflammatory disorders such as rheumatoid arthritis, as well as inflammatory bowel disease. The Feinstein study uses only noninvasive probes held against the ear.

“We now are beginning to understand its role in immune system function,” Sahn said. “All nerves release chemicals in the body to signal organs or cells how to behave. With our immune system, our vagus nerve has the ability to transmit signals to decrease overactivity.”

Sahn said that in some people, an imbalance in the vagus nerve function could contribute to autoimmune disease developing.

Dr. Lea Ann Chen, director of Inflammatory Bowel Disease Translational Research at Rutgers Robert Wood Johnson Medical School, said using vagus nerve stimulation to treat IBD is in its early stages of research, but early results, like those in the study, show promise.

“Unfortunately, we don't have medical cures for inflammatory bowel disease currently,” Chen said. “The mainstay of treatment for patients with moderate to severe disease is immunosuppression, and that increases the risk for infections and cancers. While most patients will not experience these potential adverse events … it can make patients apprehensive to start or continue appropriate therapy for their IBD.”

The pilot study included 22 people between the ages of 10 and 21 who were outpatients at Cohen Children’s Medical Center. All had mild to moderate ulcerative colitis or Crohn’s disease.

For the first two weeks, half of the participants received five minutes of vagus nerve stimulation every day. The other half received a placebo-type treatment. For the third and fourth weeks, those roles were reversed.

From the fifth week through 16th week, all participants received five minutes of stimulation, twice a day, every day.

Researchers collected information about the participants, including their symptoms, as well as issues such as anxiety and depression that can be helped by vagus nerve stimulation, Sahn said. Researchers were able to determine the level of inflammation through stool samples.

“The kids who started out with active symptoms in Crohn's disease, 50% were in clinical remission, or had no symptoms by the end of week 16,” he said. “For ulcerative colitis, one-third of the kids with active symptoms at the start were in clinical remission at the end of 16 weeks.”

Sahn noted many of the drugs used to treat these diseases are immune suppressive, which can leave kids at a higher risk of infections.

The pilot study is being followed with a larger clinical trial that will include adults up to the age of 39. Researchers also will conduct separate studies on patients who have Crohn's disease and ulcerative colitis.

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.