Methods and devices to curb appetite and/or reduce food intake

• US 20060178691A1
• Filed: 12/15/2005
• Published: 08/10/2006
• Est. Priority Date: 02/26/2004
• Status: Active Grant

• Current Assignee: Endosphere, Inc
• Original Assignee: Endosphere, Inc
• Inventors: Binmoeller, Kenneth F.
• Granted Patent: US 8,147,561 B2
• Time in Patent Office: Days
• US Class Current: 606/191
• CPC Class Codes: A61F 2002/045 Stomach, intestines
• CPC Class Codes: A61F 5/0076 preventing normal digestion, e.g. Bariatric or gastric sleeves
• CPC Class Codes: A61F 5/0079 Pyloric or esophageal obstructions
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters

Abstract

The present invention relates to methods and devices that help to curb appetite and/or reduce food intake. In one embodiment, the methods and devices of the present invention include a small intestinal/duodenal insert comprising an elongated member with at least one flow reduction element that can cause the stimulation of one or more biological signals of satiety.

Claims

1. A duodenal/small intestinal insert comprising:

an elongated member, said elongated member having a proximal end and a distal end;

an anchoring member engaged with said proximal end of said elongated member; and

at least one flow reduction element on said elongated member wherein when said anchoring member is anchored said at least one flow reduction element is in the small intestine of said organism and wherein when said duodenal/small intestinal insert is placed within an organism in this manner, said duodenal/small intestinal insert triggers an initial physiological effect that contributes to the creation of one or more biological signals of satiety.

2. The duodenal/small intestinal insert of claim 1 wherein said triggering of said initial physiological effect is caused by the slowing of the passage of consumed food through said small intestine of said organism.

3. The duodenal/small intestinal insert of claim 2 wherein said slowing of the passage of consumed food is caused by said at least one flow reduction element which comprises a diameter that is sized to restrict but not occlude the movement of consumed foods through said small intestine.

4. The duodenal/small intestinal insert of claim 3 wherein said diameter is selected from the group consisting of about 1 cm, about 2 cm and about 3 cm.

5. The duodenal/small intestinal insert of claim 1 wherein said triggering of said initial physiological effect is caused by the release of a bioactive material from said duodenal/small intestinal insert.

6. The duodenal/small intestinal insert of claim 5 wherein said bioactive material is a by-product of digestion selected from the group consisting of sugars, fatty acids, amino acids and peptides.

7. The duodenal/small intestinal insert of claim 5 wherein said bioactive material is a drug.

8. The duodenal/small intestinal insert of claim 7 wherein said drug is selected from one or more of the group consisting of altretamin, fluorouracil, amsacrin, hydroxycarbamide, asparaginase, ifosfamid, bleomycin, lomustin, busulfan, melphalan, chlorambucil, mercaptopurin, chlormethin, methotrexate, cisplatin, mitomycin, cyclophosphamide, procarbazin, cytarabin, teniposid, dacarbazin, thiotepa, dactinomycin, tioguanin, daunorubicin, treosulphan, doxorubicin, tiophosphamide, estramucin, vinblastine, etoglucide, vincristine, etoposid, vindesin, penicillin, ampicillin, nafcillin, amoxicillin, oxacillin, azlocillin, penicillin G, carbenicillin, penicillin V, dicloxacillin, phenethicillin, floxacillin, piperacillin, mecillinam, sulbenicillin, methicillin, ticarcillin, mezlocillin, cefaclor, cephalothin, cefadroxil, cephapirin, cefamandole, cephradine, cefatrizine, cefsulodine, cefazolin, ceftazidim, ceforanide, ceftriaxon, cefoxitin, cefuroxime, cephacetrile, latamoxef, cephalexin, amikacin, neomycin, dibekacyn, kanamycin, gentamycin, netilmycin, kanamycin, tobramycin, amphotericin B, novobiocin, bacitracin, nystatin, clindamycin, polymyxins, colistin, rovamycin, erythromycin, spectinomycin, lincomycin, vancomycin, chlortetracycline, oxytetracycline, demeclocycline, rolitetracycline, doxycycline, tetracycline, minocycline, chloramphenicol, rifamycin, rifampicin, thiamphenicol, sulfadiazine, sulfamethizol, sulfadimethoxin, sulfamethoxazole, sulfadimidin, sulfamethoxypyridazine, sulfafurazole, sulfaphenazol, sulfalene, sulfisomidin, sulfamerazine, sulfisoxazole, trimethoprim with sulfamethoxazole, sulfametrole, methanamine, norfloxacin, cinoxacin, nalidixic acid, nitrofurantoine, nifurtoinol, oxolinic acid;

metronidazole;

aminosalicyclic acid, isoniazide, cycloserine, rifampicine, ethambutol, tiocarlide, ethionamide, viomycin;

amithiozone, rifampicine, clofazimine, sodium sulfoxone, diaminodiphenylsulfone, amphotericin B, ketoconazole, clotrimazole, miconazole, econazole, natamycin, flucytosine, nystatine, griseofulvin, aciclovir, idoxuridine, amantidine, methisazone, cytarabine, vidarabine, ganciclovir, chloroquine, iodoquinol, clioquinol, metronidazole, dehydroemetine, paromomycin, diloxanide, furoatetinidazole, emetine, chloroquine, pyrimethamine, hydroxychloroquine, quinine, mefloquine, sulfadoxine/pyrimethamine, pentamidine, sodium suramin, primaquine, trimethoprim, proguanil, antimony potassium tartrate, niridazole, antimony sodium dimercaptosuccinate, oxamniquine, bephenium, piperazine, dichlorophen, praziquantel, diethylcarbamazine, pyrantel parmoate, hycanthone, pyrivium pamoate, levamisole, stibophen, mebendazole, tetramisole, metrifonate, thiobendazole, niclosamide, acetylsalicyclic acid, mefenamic acid, aclofenac, naproxen, azopropanone, niflumic acid, benzydamine, oxyphenbutazone, diclofenac, piroxicam, fenoprofen, pirprofen, flurbiprofen, sodium salicyclate, ibuprofensulindac, indomethacin, tiaprofenic acid, ketoprofen, tolmetin, colchicine, allopurinol, alfentanil, methadone, bezitramide, morphine, buprenorfine, nicomorphine, butorfanol, pentazocine, codeine, pethidine, dextromoramide, piritranide, dextropropoxyphene, sufentanil, fentanyl, articaine, mepivacaine, bupivacaine, prilocaine, etidocaine, procaine, lidocaine, tetracaine, amantidine, diphenhydramine, apomorphine, ethopropazine, benztropine mesylate, lergotril, biperiden, levodopa, bromocriptine, lisuride, carbidopa, metixen, chlorphenoxamine, orphenadrine, cycrimine, procyclidine, dexetimide, trihexyphenidyl, baclofen, carisoprodol, chlormezanone, chlorzoxazone, cyclobenzaprine, dantrolene, diazepam, febarbamate, mefenoxalone, mephenesin, metoxalone, methocarbamol, tolperisone, levothyronine, liothyronine, carbimazole, methimazole, methylthiouracil and propylthiouracil.

9. The duodenal/small intestinal insert of claim 5 wherein said bioactive material is a hormone.

10. The duodenal/small intestinal insert of claim 9 wherein said hormone is a natural or synthetic hormone selected from one or more of the group consisting of cortisol, deoxycorticosterone, flurohydrocortisone, beclomethasone, betamethasone, cortisone, dexamethasone, fluocinolone, fluocinonide, fluocortolone, fluorometholone, fluprednisolone, flurandrenolide, halcinonide, hydrocortisone, medrysone, methylprednisolone, paramethasone, prednisolone, prednisone, triamcinolone (acetonide), danazole, fluoxymesterone, mesterolone, dihydrotestosterone methyltestosterone, testosterone, dehydroepiandrosetone, dehydroepiandrostendione, calusterone, nandrolone, dromostanolone, oxandrolone, ethylestrenol, oxymetholone, methandriol, stanozolol methandrostenolone, testolactone, cyproterone acetate, diethylstilbestrol, estradiol, estriol, ethinylestradiol, mestranol, quinestrol chlorotrianisene, clomiphene, ethamoxytriphetol, nafoxidine, tamoxifen, allylestrenol, desogestrel, dimethisterone, dydrogesterone, ethinylestrenol, ethisterone, ethynadiol diacetate, etynodiol, hydroxyprogesterone, levonorgestrel, lynestrenol, medroxyprogesterone, megestrol acetate, norethindrone, norethisterone, norethynodrel, norgestrel, progesterone, inhibin, antidiuretic hormone, proopiomelanocortin, follicle stimulating hormone, prolactin, angiogenin, epidermal growth factor, calcitonin, erythropoietin, thyrotropic releasing hormone, insulin, growth hormones, human chorionic gonadotropin, luteinizing hormone, adrenocorticotropic hormone (ACTH), lutenizing hormone releasing hormone (LHRH), parathyroid hormone (PTH), thyrotropin releasing hormone (TRH), vasopressin and corticotropin releasing hormone.

11. The duodenal/small intestinal insert of claim 1 wherein said triggering of said initial physiological effect is caused by contact and/or pressure exerted on the wall of said small intestine by said duodenal/small intestinal insert.

12. The duodenal/small intestinal insert of claim 1 wherein said triggering of said initial physiological effect occurs through the activation of at least one chemoreceptor.

13. The duodenal/small intestinal insert of claim 1 wherein said triggering of said initial physiological effect occurs through the activation of at least one stretch receptor.

14. The duodenal/small intestinal insert of claim 1 wherein said triggering of said initial physiological effect occurs through the activation of at least one mechanoreceptor.

15. The duodenal/small intestinal insert of claim 1 wherein said one or more biological signals of satiety is transmitted at least in part through stimulation of afferent nerve fibers.

16. The duodenal/small intestinal insert of claim 15 wherein said afferent nerve fibers are vagal afferent nerve fibers.

17. The duodenal/small intestinal insert of claim 12 wherein said one or more biological signals of satiety is transmitted at least in part by molecules released as a result of said activation of said chemoreceptor.

18. The duodenal/small intestinal insert of claim 17 wherein said molecules are hormones.

19. The duodenal/small intestinal insert of claim 17 wherein said molecules are selected from the group consisting of cholecystokinin, peptide YY_3-36, glucagon-like peptide 1, gastric-inhibitory peptide, neurotensin, amylin, leptin, bombesin, calcitonin, calcitonin gene-related peptide, somatostatin, neuromedin U and glucagon.

20. The duodenal/small intestinal insert of claim 17 wherein said molecules activate a receptor in the periphery to cause a subsequent physiological effect.

21. The duodenal/small intestinal insert of claim 19 wherein said molecules activate a receptor in the liver to cause a subsequent physiological effect.

22. The duodenal/small intestinal insert of claim 19 wherein said molecules activate a receptor in the pylorus to cause a subsequent physiological effect.

23. The duodenal/small intestinal insert of claim 19 wherein said molecules activate a receptor in the stomach to cause a subsequent physiological effect.

24. The duodenal/small intestinal insert of claim 17 wherein said molecules activate a receptor in the brain to cause a subsequent physiological effect.

25. The duodenal/small intestinal insert of claim 1 wherein said elongated member further comprises at least one angle that matches an angle of said organism'"'"'s small intestine.

26. The duodenal/small intestinal insert of claim 1 wherein said elongated member further comprises an angle selected from the group consisting of about 70°

, about 71°

, about 72°

, about 73°

, about 74°

, about 75°

, about 76°

, about 77°

, about 78°

, about 79°

, about 80°

, about 81°

, about 82°

, about 83°

, about 84°

, about 85°

, about 86°

, about 87°

, about 88°

, about 89°

, and about 90°

.

27. The duodenal/small intestinal insert of claim 1 wherein said elongated member further comprises an angle of about 80°

.

28. The duodenal/small intestinal insert of claim 25, comprising two angles, each matching an angle of said organism'"'"'s small intestine.

54. A method comprising:

positioning the duodenal/small intestinal insert of claim 1 in an organism.

55. The method of claim 54 wherein said triggering of said initial physiological effect is caused by the slowing of the passage of consumed food through said small intestine of said organism.

56. The method of claim 55 wherein said slowing of the passage of consumed food is caused by said at least one flow reduction element which comprises a diameter that is sized to restrict but not occlude the movement of consumed foods through said small intestine.

57. The method of claim 56 wherein said diameter is selected from the group consisting of about 1 cm, about 2 cm and about 3 cm.

58. The method of claim 54 wherein said triggering of said initial physiological effect is caused by the release of a bioactive material from said duodenal/small intestinal insert.

59. The method of claim 54 wherein said bioactive material is a by-product of digestion selected from the group consisting of sugars, fatty acids, amino acids and peptides.

60. The method of claim 54 wherein said bioactive material is a drug.

61. The duodenal/small intestinal insert of claim 60 wherein said drug is selected from one or more of the group consisting of altretamin, fluorouracil, amsacrin, hydroxycarbamide, asparaginase, ifosfamid, bleomycin, lomustin, busulfan, melphalan, chlorambucil, mercaptopurin, chlormethin, methotrexate, cisplatin, mitomycin, cyclophosphamide, procarbazin, cytarabin, teniposid, dacarbazin, thiotepa, dactinomycin, tioguanin, daunorubicin, treosulphan, doxorubicin, tiophosphamide, estramucin, vinblastine, etoglucide, vincristine, etoposid, vindesin, penicillin, ampicillin, nafcillin, amoxicillin, oxacillin, aziocillin, penicillin G, carbenicillin, penicillin V, dicloxacillin, phenethicillin, floxacillin, piperacillin, mecillinam, sulbenicillin, methicillin, ticarcillin, mezlocillin, cefaclor, cephalothin, cefadroxil, cephapirin, cefamandole, cephradine, cefatrizine, cefsulodine, cefazolin, ceftazidim, ceforanide, ceftriaxon, cefoxitin, cefuroxime, cephacetrile, latamoxef, cephalexin, amikacin, neomycin, dibekacyn, kanamycin, gentamycin, netilmycin, kanamycin, tobramycin, amphotericin B, novobiocin, bacitracin, nystatin, clindamycin, polymyxins, colistin, rovamycin, erythromycin, spectinomycin, lincomycin, vancomycin, chlortetracycline, oxytetracycline, demeclocycline, rolitetracycline, doxycycline, tetracycline, minocycline, chloramphenicol, rifamycin, rifampicin, thiamphenicol, sulfadiazine, sulfamethizol, sulfadimethoxin, sulfamethoxazole, sulfadimidin, sulfamethoxypyridazine, sulfafurazole, sulfaphenazol, sulfalene, sulfisomidin, sulfamerazine, sulfisoxazole, trimethoprim with sulfamethoxazole, sulfametrole, methanamine, norfloxacin, cinoxacin, nalidixic acid, nitrofurantoine, nifurtoinol, oxolinic acid;

metronidazole;

aminosalicyclic acid, isoniazide, cycloserine, rifampicine, ethambutol, tiocarlide, ethionamide, viomycin;

amithiozone, rifampicine, clofazimine, sodium sulfoxone, diaminodiphenylsulfone, amphotericin B, ketoconazole, clotrimazole, miconazole, econazole, natamycin, flucytosine, nystatine, griseofulvin, aciclovir, idoxuridine, amantidine, methisazone, cytarabine, vidarabine, ganciclovir, chloroquine, iodoquinol, clioquinol, metronidazole, dehydroemetine, paromomycin, diloxanide, furoatetinidazole, emetine, chloroquine, pyrimethamine, hydroxychloroquine, quinine, mefloquine, sulfadoxine/pyrimethamine, pentamidine, sodium suramin, primaquine, trimethoprim, proguanil, antimony potassium tartrate, niridazole, antimony sodium dimercaptosuccinate, oxamniquine, bephenium, piperazine, dichlorophen, praziquantel, diethylcarbamazine, pyrantel parmoate, hycanthone, pyrivium pamoate, levamisole, stibophen, mebendazole, tetramisole, metrifonate, thiobendazole, niclosamide, acetylsalicyclic acid, mefenamic acid, aclofenac, naproxen, azopropanone, niflumic acid, benzydamine, oxyphenbutazone, diclofenac, piroxicam, fenoprofen, pirprofen, flurbiprofen, sodium salicyclate, ibuprofensulindac, indomethacin, tiaprofenic acid, ketoprofen, tolmetin, colchicine, allopurinol, alfentanil, methadone, bezitramide, morphine, buprenorfine, nicomorphine, butorfanol, pentazocine, codeine, pethidine, dextromoramide, piritranide, dextropropoxyphene, sufentanil, fentanyl, articaine, mepivacaine, bupivacaine, prilocaine, etidocaine, procaine, lidocaine, tetracaine, amantidine, diphenhydramine, apomorphine, ethopropazine, benztropine mesylate, lergotril, biperiden, levodopa, bromocriptine, lisuride, carbidopa, metixen, chlorphenoxamine, orphenadrine, cycrimine, procyclidine, dexetimide, trihexyphenidyl, baclofen, carisoprodol, chlormezanone, chlorzoxazone, cyclobenzaprine, dantrolene, diazepam, febarbamate, mefenoxalone, mephenesin, metoxalone, methocarbamol, tolperisone, levothyronine, liothyronine, carbimazole, methimazole, methylthiouracil and propylthiouracil.

62. The method of claim 54 wherein said bioactive material is a hormone.

63. The method of claim 62 wherein said hormone is a natural or synthetic hormone selected from one or more of the group consisting of cortisol, deoxycorticosterone, flurohydrocortisone, beclomethasone, betamethasone, cortisone, dexamethasone, fluocinolone, fluocinonide, fluocortolone, fluorometholone, fluprednisolone, flurandrenolide, halcinonide, hydrocortisone, medrysone, methylprednisolone, paramethasone, prednisolone, prednisone, triamcinolone (acetonide), danazole, fluoxymesterone, mesterolone, dihydrotestosterone methyltestosterone, testosterone, dehydroepiandrosetone, dehydroepiandrostendione, calusterone, nandrolone, dromostanolone, oxandrolone, ethylestrenol, oxymetholone, methandriol, stanozolol methandrostenolone, testolactone, cyproterone acetate, diethylstilbestrol, estradiol, estriol, ethinylestradiol, mestranol, quinestrol chlorotrianisene, clomiphene, ethamoxytriphetol, nafoxidine, tamoxifen, allylestrenol, desogestrel, dimethisterone, dydrogesterone, ethinylestrenol, ethisterone, ethynadiol diacetate, etynodiol, hydroxyprogesterone, levonorgestrel, lynestrenol, medroxyprogesterone, megestrol acetate, norethindrone, norethisterone, norethynodrel, norgestrel, progesterone, inhibin, antidiuretic hormone, proopiomelanocortin, follicle stimulating hormone, prolactin, angiogenin, epidermal growth factor, calcitonin, erythropoietin, thyrotropic releasing hormone, insulin, growth hormones, human chorionic gonadotropin, luteinizing hormone, adrenocorticotropic hormone (ACTH), lutenizing hormone releasing hormone (LHRH), parathyroid hormone (PTH), thyrotropin releasing hormone (TRH), vasopressin and corticotropin releasing hormone.

64. The method of claim 54 wherein said triggering of said initial physiological effect is caused by contact and/or pressure exerted on the wall of said small intestine of said organism by said duodenal/small intestinal insert.

65. The method of claim 54 wherein said triggering of said initial physiological effect occurs through the activation of at least one chemoreceptor.

66. The method of claim 54 wherein said triggering of said initial physiological effect occurs through the activation of at least one stretch receptor.

67. The method of claim 54 wherein said triggering of said initial physiological effect occurs through the activation of at least one mechanoreceptor.

68. The method of claim 54 wherein said one or more biological signals of satiety is transmitted at least in part through stimulation of afferent nerve fibers.

69. The method of claim 68 wherein said afferent nerve fibers are vagal afferent nerve fibers.

70. The method of claim 65 wherein said one or more biological signals of satiety is transmitted at least in part by molecules released as a result of said activation of said chemoreceptor.

71. The method of claim 70 wherein said molecules are hormones.

72. The method of claim 70 wherein said molecules are selected from the group consisting of cholecystokinin, peptide YY_3-36, glucagon-like peptide 1, gastric-inhibitory peptide, neurotensin, amylin, leptin, bombesin, calcitonin, calcitonin gene-related peptide, somatostatin, neuromedin U and glucagon.

73. The method of claim 70 wherein said molecules activate a receptor in the periphery to cause a subsequent physiological effect.

74. The method of claim 73 wherein said molecules activate a receptor in the liver to cause a subsequent physiological effect.

75. The method of claim 73 wherein said molecules activate a receptor in the pylorus to cause a subsequent physiological effect.

76. The method of claim 70 wherein said molecules activate a receptor in the stomach to cause a subsequent physiological effect.

77. The method of claim 70 wherein said molecules activate a receptor in the brain to cause a subsequent physiological effect.

78. The method of claim 54 wherein said elongated member further comprises at least one angle that matches an angle of said organism'"'"'s small intestine.

79. The method of claim 54 wherein said elongated member further comprises an angle selected from the group consisting of about 70°

, about 71°

, about 72°

, about 73°

, about 74°

, about 75°

, about 76°

, about 77°

, about 78°

, about 79°

, about 80°

, about 81°

, about 82°

, about 83°

, about 84°

, about 85°

, about 86°

, about 87°

, about 88°

, about 89°

, and about 90°

.

80. The method of claim 54 wherein said elongated member further comprises an angle of about 80°

.

81. The method of claim 78, comprising two angles, each matching an angle of said organism'"'"'s small intestine.

29. A duodenal/small intestinal insert comprising:

an elongated member with at least one angle and at least one flow reduction element wherein said at least one angle matches an angle in the small intestine of an organism and wherein said at least one flow reduction element has a diameter that is less than the diameter of said small intestine of said organism and wherein said at least one angle and said at least one flow reduction element allow said duodenal/small intestinal insert to lodge in said small intestine of said organism such that it remains in said small intestine for a period of time and wherein said insert triggers an initial physiological effect that contributes to the creation of one or more biological signals of satiety.

30. The duodenal/small intestinal insert of claim 29 wherein said triggering of said initial physiological effect is caused by the slowing of the passage of consumed food through said small intestine of said organism.

31. The duodenal/small intestinal insert of claim 30 wherein said slowing of the passage of consumed food is caused by the diameter of said at least one flow reduction element which is sized to restrict but not occlude the movement of consumed foods through said small intestine.

33. The duodenal/small intestinal insert of claim 29 wherein said triggering of said initial physiological effect is caused by the release of a bioactive material from said duodenal/small intestinal insert.

34. The duodenal/small intestinal insert of claim 33 wherein said bioactive material is a by-product of digestion selected from the group consisting of sugars, fatty acids, amino acids and peptides.

35. The duodenal/small intestinal insert of claim 33 wherein said bioactive material is a drug.

36. The duodenal/small intestinal insert of claim 35 wherein said drug is selected from one or more of the group consisting of altretamin, fluorouracil, amsacrin, hydroxycarbamide, asparaginase, ifosfamid, bleomycin, lomustin, busulfan, melphalan, chlorambucil, mercaptopurin, chlormethin, methotrexate, cisplatin, mitomycin, cyclophosphamide, procarbazin, cytarabin, teniposid, dacarbazin, thiotepa, dactinomycin, tioguanin, daunorubicin, treosulphan, doxorubicin, tiophosphamide, estramucin, vinblastine, etoglucide, vincristine, etoposid, vindesin, penicillin, ampicillin, nafcillin, amoxicillin, oxacillin, azlocillin, penicillin G, carbenicillin, penicillin V, dicloxacillin, phenethicillin, floxacillin, piperacillin, mecillinam, sulbenicillin, methicillin, ticarcillin, mezlocillin, cefaclor, cephalothin, cefadroxil, cephapirin, cefamandole, cephradine, cefatrizine, cefsulodine, cefazolin, ceftazidim, ceforanide, ceftriaxon, cefoxitin, cefuroxime, cephacetrile, latamoxef, cephalexin, amikacin, neomycin, dibekacyn, kanamycin, gentamycin, netilmycin, kanamycin, tobramycin, amphotericin B, novobiocin, bacitracin, nystatin, clindamycin, polymyxins, colistin, rovamycin, erythromycin, spectinomycin, lincomycin, vancomycin, chlortetracycline, oxytetracycline, demeclocycline, rolitetracycline, doxycycline, tetracycline, minocycline, chloramphenicol, rifamycin, rifampicin, thiamphenicol, sulfadiazine, sulfamethizol, sulfadimethoxin, sulfamethoxazole, sulfadimidin, sulfamethoxypyridazine, sulfafurazole, sulfaphenazol, sulfalene, sulfisomidin, sulfamerazine, sulfisoxazole, trimethoprim with sulfamethoxazole, sulfametrole, methanamine, norfloxacin, cinoxacin, nalidixic acid, nitrofurantoine, nifurtoinol, oxolinic acid;

metronidazole;

aminosalicyclic acid, isoniazide, cycloserine, rifampicine, ethambutol, tiocarlide, ethionamide, viomycin;

amithiozone, rifampicine, clofazimine, sodium sulfoxone, diaminodiphenylsulfone, amphotericin B, ketoconazole, clotrimazole, miconazole, econazole, natamycin, flucytosine, nystatine, griseofulvin, aciclovir, idoxuridine, amantidine, methisazone, cytarabine, vidarabine, ganciclovir, chloroquine, iodoquinol, clioquinol, metronidazole, dehydroemetine, paromomycin, diloxanide, furoatetinidazole, emetine, chloroquine, pyrimethamine, hydroxychloroquine, quinine, mefloquine, sulfadoxine/pyrimethamine, pentamidine, sodium suramin, primaquine, trimethoprim, proguanil, antimony potassium tartrate, niridazole, antimony sodium dimercaptosuccinate, oxamniquine, bephenium, piperazine, dichlorophen, praziquantel, diethylcarbamazine, pyrantel parmoate, hycanthone, pyrivium pamoate, levamisole, stibophen, mebendazole, tetramisole, metrifonate, thiobendazole, niclosamide, acetylsalicyclic acid, mefenamic acid, aclofenac, naproxen, azopropanone, niflumic acid, benzydamine, oxyphenbutazone, diclofenac, piroxicam, fenoprofen, pirprofen, flurbiprofen, sodium salicyclate, ibuprofensulindac, indomethacin, tiaprofenic acid, ketoprofen, tolmetin, colchicine, allopurinol, alfentanil, methadone, bezitramide, morphine, buprenorfine, nicomorphine, butorfanol, pentazocine, codeine, pethidine, dextromoramide, piritranide, dextropropoxyphene, sufentanil, fentanyl, articaine, mepivacaine, bupivacaine, prilocaine, etidocaine, procaine, lidocaine, tetracaine, amantidine, diphenhydramine, apomorphine, ethopropazine, benztropine mesylate, lergotril, biperiden, levodopa, bromocriptine, lisuride, carbidopa, metixen, chlorphenoxamine, orphenadrine, cycrimine, procyclidine, dexetimide, trihexyphenidyl, baclofen, carisoprodol, chlormezanone, chlorzoxazone, cyclobenzaprine, dantrolene, diazepam, febarbamate, mefenoxalone, mephenesin, metoxalone, methocarbamol, tolperisone, levothyronine, liothyronine, carbimazole, methimazole, methylthiouracil and propylthiouracil.

37. The duodenal/small intestinal insert of claim 33 wherein said bioactive material is a hormone.

38. The duodenal/small intestinal insert of claim 37 wherein said hormone is a natural or synthetic hormone selected from one or more of the group consisting of cortisol, deoxycorticosterone, flurohydrocortisone, beclomethasone, betamethasone, cortisone, dexamethasone, fluocinolone, fluocinonide, fluocortolone, fluorometholone, fluprednisolone, flurandrenolide, halcinonide, hydrocortisone, medrysone, methylprednisolone, paramethasone, prednisolone, prednisone, triamcinolone (acetonide), danazole, fluoxymesterone, mesterolone, dihydrotestosterone methyltestosterone, testosterone, dehydroepiandrosetone, dehydroepiandrostendione, calusterone, nandrolone, dromostanolone, oxandrolone, ethylestrenol, oxymetholone, methandriol, stanozolol methandrostenolone, testolactone, cyproterone acetate, diethylstilbestrol, estradiol, estriol, ethinylestradiol, mestranol, quinestrol chlorotrianisene, clomiphene, ethamoxytriphetol, nafoxidine, tamoxifen, allylestrenol, desogestrel, dimethisterone, dydrogesterone, ethinylestrenol, ethisterone, ethynadiol diacetate, etynodiol, hydroxyprogesterone, levonorgestrel, lynestrenol, medroxyprogesterone, megestrol acetate, norethindrone, norethisterone, norethynodrel, norgestrel, progesterone, inhibin, antidiuretic hormone, proopiomelanocortin, follicle stimulating hormone, prolactin, angiogenin, epidermal growth factor, calcitonin, erythropoietin, thyrotropic releasing hormone, insulin, growth hormones, human chorionic gonadotropin, luteinizing hormone, adrenocorticotropic hormone (ACTH), lutenizing hormone releasing hormone (LHRH), parathyroid hormone (PTH), thyrotropin releasing hormone (TRH), vasopressin and corticotropin releasing hormone.

39. The duodenal/small intestinal insert of claim 29 wherein said triggering of said initial physiological effect is caused by contact and/or pressure exerted on the wall of said small intestine of said organism by said duodenal/small intestinal insert.

40. The duodenal/small intestinal insert of claim 29 wherein said triggering of said initial physiological effect occurs through the activation of at least chemoreceptor.

41. The duodenal/small intestinal insert of claim 29 wherein said triggering of said initial physiological effect occurs through the activation of at least one stretch receptor.

42. The duodenal/small intestinal insert of claim 29 wherein said triggering of said initial physiological effect occurs through the activation of at least one mechanoreceptor.

43. The duodenal/small intestinal insert of claim 29 wherein said one or more biological signals of satiety is transmitted at least in part through stimulation of afferent nerve fibers.

44. The duodenal/small intestinal insert of claim 43 wherein said afferent nerve fibers are vagal afferent nerve fibers.

45. The duodenal/small intestinal insert of claim 40 wherein said one or more biological signals of satiety is transmitted at least in part by molecules released as a result of said activation of said chemoreceptor.

46. The duodenal/small intestinal insert of claim 45 wherein said molecules are hormones.

47. The duodenal/small intestinal insert of claim 45 wherein said molecules are selected from the group consisting of cholecystokinin, peptide YY_3-36, glucagon-like peptide 1, gastric-inhibitory peptide, neurotensin, amylin, leptin, bombesin, calcitonin, calcitonin gene-related peptide, somatostatin, neuromedin U and glucagon.

48. The duodenal/small intestinal insert of claim 45 wherein said molecules activate a receptor in the periphery to cause a subsequent physiological effect.

49. The duodenal/small intestinal insert of claim 48 wherein said molecules activate a receptor in the liver to cause a subsequent physiological effect.

50. The duodenal/small intestinal insert of claim 48 wherein said molecules activate a receptor to cause in the pylorus a subsequent physiological effect.

51. The duodenal/small intestinal insert of claim 45 wherein said molecules activate a receptor in the brain to cause a subsequent physiological effect.

52. The duodenal/small intestinal insert of claim 29 wherein said elongated member further comprises an angle selected from the group consisting of about 70°

, about 71°

, about 72°

, about 73°

, about 74°

, about 75°

, about 76°

, about 77°

, about 78°

, about 79°

, about 80°

, about 81°

, about 82°

, about 83°

, about 84°

, about 85°

, about 86°

, about 87°

, about 88°

, about 89°

, and about 90°

.

53. The duodenal/small intestinal insert of claim 29 wherein said elongated member further comprises an angle of about 80°

.

82. A method comprising:

positioning a duodenal/small intestinal insert of claim 29 in an organism.

83. The method of claim 82 wherein said diameter of said at least one flow reduction element is sized to restrict but not occlude the movement of consumed foods through said small intestine.

84. The method of claim 83 wherein said diameter of said at least one flow reduction element is about 1 cm to about 3 cm.

85. The method of claim 82 wherein said triggering of said initial physiological effect is caused by the slowing of the passage of consumed food through said small intestine of said organism.

86. The method of claim 82 wherein said triggering of said initial physiological effect is caused by the release of a bioactive material from said duodenal/small intestinal insert.

87. The method of claim 86 wherein said bioactive material is a by-product of digestion selected from the group consisting of sugars, fatty acids, amino acids and peptides.

88. The method of claim 86 wherein said bioactive material is a drug.

89. The duodenal/small intestinal insert of claim 88 wherein said drug is selected from one or more of the group consisting of altretamin, fluorouracil, amsacrin, hydroxycarbamide, asparaginase, ifosfamid, bleomycin, lomustin, busulfan, melphalan, chlorambucil, mercaptopurin, chlormethin, methotrexate, cisplatin, mitomycin, cyclophosphamide, procarbazin, cytarabin, teniposid, dacarbazin, thiotepa, dactinomycin, tioguanin, daunorubicin, treosulphan, doxorubicin, tiophosphamide, estramucin, vinblastine, etoglucide, vincristine, etoposid, vindesin, penicillin, ampicillin, nafcillin, amoxicillin, oxacillin, aziocillin, penicillin G, carbenicillin, penicillin V, dicloxacillin, phenethicillin, floxacillin, piperacillin, mecillinam, sulbenicillin, methicillin, ticarcillin, mezlocillin, cefaclor, cephalothin, cefadroxil, cephapirin, cefamandole, cephradine, cefatrizine, cefsulodine, cefazolin, ceftazidim, ceforanide, ceftriaxon, cefoxitin, cefuroxime, cephacetrile, latamoxef, cephalexin, amikacin, neomycin, dibekacyn, kanamycin, gentamycin, netilmycin, kanamycin, tobramycin, amphotericin B, novobiocin, bacitracin, nystatin, clindamycin, polymyxins, colistin, rovamycin, erythromycin, spectinomycin, lincomycin, vancomycin, chlortetracycline, oxytetracycline, demeclocycline, rolitetracycline, doxycycline, tetracycline, minocycline, chloramphenicol, rifamycin, rifampicin, thiamphenicol, sulfadiazine, sulfamethizol, sulfadimethoxin, sulfamethoxazole, sulfadimidin, sulfamethoxypyridazine, sulfafurazole, sulfaphenazol, sulfalene, sulfisomidin, sulfamerazine, sulfisoxazole, trimethoprim with sulfamethoxazole, sulfametrole, methanamine, norfloxacin, cinoxacin, nalidixic acid, nitrofurantoine, nifurtoinol, oxolinic acid;

metronidazole;

aminosalicyclic acid, isoniazide, cycloserine, rifampicine, ethambutol, tiocarlide, ethionamide, viomycin;

amithiozone, rifampicine, clofazimine, sodium sulfoxone, diaminodiphenylsulfone, amphotericin B, ketoconazole, clotrimazole, miconazole, econazole, natamycin, flucytosine, nystatine, griseofulvin, aciclovir, idoxuridine, amantidine, methisazone, cytarabine, vidarabine, ganciclovir, chloroquine, iodoquinol, clioquinol, metronidazole, dehydroemetine, paromomycin, diloxanide, furoatetinidazole, emetine, chloroquine, pyrimethamine, hydroxychloroquine, quinine, mefloquine, sulfadoxine/pyrimethamine, pentamidine, sodium suramin, primaquine, trimethoprim, proguanil, antimony potassium tartrate, niridazole, antimony sodium dimercaptosuccinate, oxamniquine, bephenium, piperazine, dichlorophen, praziquantel, diethylcarbamazine, pyrantel parmoate, hycanthone, pyrivium pamoate, levamisole, stibophen, mebendazole, tetramisole, metrifonate, thiobendazole, niclosamide, acetylsalicyclic acid, mefenamic acid, aclofenac, naproxen, azopropanone, niflumic acid, benzydamine, oxyphenbutazone, diclofenac, piroxicam, fenoprofen, pirprofen, flurbiprofen, sodium salicyclate, ibuprofensulindac, indomethacin, tiaprofenic acid, ketoprofen, tolmetin, colchicine, allopurinol, alfentanil, methadone, bezitramide, morphine, buprenorfine, nicomorphine, butorfanol, pentazocine, codeine, pethidine, dextromoramide, piritranide, dextropropoxyphene, sufentanil, fentanyl, articaine, mepivacaine, bupivacaine, prilocaine, etidocaine, procaine, lidocaine, tetracaine, amantidine, diphenhydramine, apomorphine, ethopropazine, benztropine mesylate, lergotril, biperiden, levodopa, bromocriptine, lisuride, carbidopa, metixen, chlorphenoxamine, orphenadrine, cycrimine, procyclidine, dexetimide, trihexyphenidyl, baclofen, carisoprodol, chlormezanone, chlorzoxazone, cyclobenzaprine, dantrolene, diazepam, febarbamate, mefenoxalone, mephenesin, metoxalone, methocarbamol, tolperisone, levothyronine, liothyronine, carbimazole, methimazole, methylthiouracil and propylthiouracil.

90. The method of claim 86 wherein said bioactive material is a hormone.

91. The method of claim 90 wherein said hormone is a natural or synthetic hormone selected from one or more of the group consisting of cortisol, deoxycorticosterone, flurohydrocortisone, beclomethasone, betamethasone, cortisone, dexamethasone, fluocinolone, fluocinonide, fluocortolone, fluorometholone, fluprednisolone, flurandrenolide, halcinonide, hydrocortisone, medrysone, methylprednisolone, paramethasone, prednisolone, prednisone, triamcinolone (acetonide), danazole, fluoxymesterone, mesterolone, dihydrotestosterone methyltestosterone, testosterone, dehydroepiandrosetone, dehydroepiandrostendione, calusterone, nandrolone, dromostanolone, oxandrolone, ethylestrenol, oxymetholone, methandriol, stanozolol methandrostenolone, testolactone, cyproterone acetate, diethylstilbestrol, estradiol, estriol, ethinylestradiol, mestranol, quinestrol chlorotrianisene, clomiphene, ethamoxytriphetol, nafoxidine, tamoxifen, allylestrenol, desogestrel, dimethisterone, dydrogesterone, ethinylestrenol, ethisterone, ethynadiol diacetate, etynodiol, hydroxyprogesterone, levonorgestrel, lynestrenol, medroxyprogesterone, megestrol acetate, norethindrone, norethisterone, norethynodrel, norgestrel, progesterone, inhibin, antidiuretic hormone, proopiomelanocortin, follicle stimulating hormone, prolactin, angiogenin, epidermal growth factor, calcitonin, erythropoietin, thyrotropic releasing hormone, insulin, growth hormones, human chorionic gonadotropin, luteinizing hormone, adrenocorticotropic hormone (ACTH), lutenizing hormone releasing hormone (LHRH), parathyroid hormone (PTH), thyrotropin releasing hormone (TRH), vasopressin and corticotropin releasing hormone.

92. The method of claim 82 wherein said triggering of said initial physiological effect is caused by contact and/or pressure exerted on the wall of said small intestine of said organism by said duodenal/small intestinal insert.

93. The method of claim 82 wherein said triggering of said initial physiological effect occurs through the activation of at least one chemoreceptor.

94. The method of claim 82 wherein said triggering of said initial physiological effect occurs through the activation of at least one stretch receptor.

95. The method of claim 82 wherein said triggering of said initial physiological effect occurs through the activation of at least one mechanoreceptor.

96. The method of claim 82 wherein said one or more biological signals of satiety is transmitted at least in part through stimulation of afferent nerve fibers.

97. The method of claim 96 wherein said afferent nerve fibers are vagal afferent nerve fibers.

98. The method of claim 93 wherein said one or more biological signals of satiety is transmitted at least in part by molecules released as a result of said activation of said chemoreceptor.

99. The method of claim 98 wherein said molecules are hormones.

100. The method of claim 98 wherein said molecules are selected from the group consisting of cholecystokinin, peptide YY3-36, glucagon-like peptide 1, gastric-inhibitory peptide, neurotensin, amylin, leptin, bombesin, calcitonin, calcitonin gene-related peptide, somatostatin, neuromedin U and glucagon.

101. The method of claim 98 wherein said molecules activate a receptor in the periphery to cause a subsequent physiological effect.

102. The method of claim 101 wherein said molecules activate a receptor in the liver to cause a subsequent physiological effect.

103. The method of claim 101 wherein said molecules activate a receptor in the pylorus to cause a subsequent physiological effect.

104. The method of claim 101 wherein said molecules activate a receptor in the stomach to cause a subsequent physiological effect.

105. The method of claim 98 wherein said molecules activate a receptor in the brain to cause a subsequent physiological effect.

106. The method of claim 82 wherein said elongated member further comprises an angle selected from the group consisting of about 70°

, about 71°

, about 72°

, about 73°

, about 74°

, about 75°

, about 76°

, about 77°

, about 78°

, about 79°

, about 80°

, about 81°

, about 82°

, about 83°

, about 84°

, about 85°

, about 86°

, about 87°

, about 88°

, about 89°

, and about 90°

.

107. The method of claim 82 wherein said elongated member further comprises an angle of about 80°

.

32. The duodenal/small intestinal insert of claim 32 wherein said diameter of said at least one flow reduction element is about 1 cm to about 3 cm.