The outcome of treatment of gastroparesis with prokinetic and anti-emetic drugs remains unsatisfactory in some patients. Gastric electrical stimulation has been proposed as an alternative therapeutic option.
A study by Dr Thomas Abell and colleagues investigated the efficacy of gastric electrical stimulation for the treatment of symptomatic gastroparesis unresponsive to standard medical therapy.
33 patients with chronic symptomatic gastroparesis received continuous high-frequency, low-energy gastric electrical stimulation.
Electrical stimulation was given via electrodes in the muscle wall of the antrum connected to a neurostimulator in an abdominal wall pocket.
After implantation of electrodes, patients were randomized to receive stimulation (ON) or no stimulation (OFF) for a 1-month period. After 1 month all patients received stimulation for at least 11 months.
In the first month of the study, self-reported vomiting frequency was significantly reduced in the ON vs. OFF group. Symptomatic improvement was consistent with the significant patient preference for electrical stimulation.
Vomiting frequency had decreased significantly when patients were evaluated 6 and 12 months after initiation of treatment.
Scores for symptom severity and quality of life significantly improved at 6 and 12 months, whereas gastric emptying was only modestly accelerated.
Electrical stimulation significantly improved quality of life in patients with severe gastroparesis.
|Dr Thomas Abell|
5 out of the 33 patients had their gastric electrical stimulation system explanted or revised due to infection or other complications.