Introduction: Proximal duodenal electrical stimulation with various energy parameters has been investigated as a possible treatment for various gastrointestinal (GI) myoelectrical diseases. Wide pulse width (millisecond) stimulation in the proximal duodenum can disrupt or entrain the normal myoelectrical rhythm and provide a potential feedback pathway to alter normal gastric function such as emptying, fundus tone, and intra-gastric pressure and subsequently produce specific symptoms that could affect eating behaviors. A specific level of electrical stimulation is necessary to elicit symptoms and serve as an indicator that energy parameters are adequate. However, there has been no published data correlating electrical threshold stimulation with symptom characterization. The goal of this study was to determine the average minimum pulse width necessary to elicit GI symptoms. Methods: Eight patients underwent endoscopic placement of intraluminal electrodes in the proximal duodenum. Each patient received electrical stimulation in the millisecond (ms) range starting with a pulse width of 100 ms that was increased by intervals of 100 ms up to a maximum pulse width of 500 ms. The pulse repetition frequency was fixed at 12 CPM and each regimen was repeated for amplitudes ranging from 2 milliamps (mA) to 10 mA. Gastrointestinal symptom scores consisting of nausea, vomiting, satiety, fullness, pain, bloating and other, were taken at baseline and after each regimen change. Results: There was an average minimum threshold necessary for elicitation of symptoms (293.7 41.7 ms, p-value = 0.063). The three most frequently reported GI symptoms were crampy abdominal pain, fullness, and bloating. Conclusions: Electrical stimulation of the duodenum is feasible. A certain minimum threshold of duodenal electrical stimulation is necessary to elicit GI symptoms in patients. The intensity and patient tolerability of each specific GI symptom was able to be adjusted by changing a certain energy parameter within a regimen. Further research is warranted to evaluate the ability of duodenal electrical stimulation to produce GI symptoms that may alter eating behaviors. [ABSTRACT FROM AUTHOR]