Gastric electrical stimulation in intractable symptomatic gastroparesis

• Published in: Digestion Vol. 66; no. 4; p. 204
• Main Authors: Abell, Thomas L, Van Cutsem, Eric, Abrahamsson, Hasse, Huizinga, Jan D, Konturek, J W, Galmiche, Jean Paul, VoelIer, Guy, Filez, Ludo, Everts, Bernt, Waterfall, William E, Domschke, W, Bruley des Varannes, Stanislas, Familoni, Babajide O, Bourgeois, Ivan M, Janssens, Jozef, Tougas, Gervais
• Format: Journal Article
• Language: English
• Published: Switzerland 01-01-2002
• Subjects: Adolescent; Adult; Electric Stimulation Therapy - adverse effects; Electrodes, Implanted; Feasibility Studies; Female; Gastric Emptying; Gastroparesis - etiology; Gastroparesis - physiopathology; Gastroparesis - therapy; Humans; Male; Middle Aged; Nausea - therapy; Transcutaneous Electric Nerve Stimulation; Vomiting - therapy; Weight Gain
• ISSN: 0012-2823
• DOI: 10.1159/000068359

The treatment of gastroparesis remains unsatisfactory despite prokinetic and anti-emetic drugs. Gastric electrical stimulation has been proposed as a therapeutic option. We have assessed the effect of gastric electrical stimulation on symptoms, medical treatment, body weight and gastric emptying in patients with intractable symptomatic gastroparesis in a non-placebo-controlled study.
In this multicenter study, 38 highly symptomatic patients with drug-refractory gastroparesis were enrolled. Patients first received temporary electrical stimulation using percutaneous electrodes. The 33 responders to temporary stimulation then underwent surgical implantation of a permanent stimulator. Severity of vomiting and nausea was assessed before and after stimulation. Patients were reassessed 3, 6, and 12 months after permanent implantation.
With stimulation, 35/38 patients (97%) experienced >80% reduction in vomiting and nausea. This effect persisted throughout the observation period (2.9-15.6 months, 341 patient-months). Gastric emptying did not initially change, but improved in most patients at 12 months. At 1 year, the average weight gain was 5.5% and 9/14 patients initially receiving enteral or parenteral nutrition were able to discontinue it.
Electrical stimulation of the stomach has an immediate and potent anti-emetic effect. It offers a safe and effective alternative for patients with intractable symptomatic gastroparesis.