title: Gastric electrical stimulation in intractable symptomatic gastroparesis.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Mississippi Medical Center, Jackson, Miss 39216-4505, USA. tabell@medicine.umsmed.edu
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Abell
authors.forename: Eric
authors.initials: E
authors.lastname: Van Cutsem
authors.forename: Hasse
authors.initials: H
authors.lastname: Abrahamsson
authors.forename: Jan D
authors.initials: JD
authors.lastname: Huizinga
authors.forename: J W
authors.initials: JW
authors.lastname: Konturek
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Galmiche
authors.forename: Guy
authors.initials: G
authors.lastname: VoelIer
authors.forename: Ludo
authors.initials: L
authors.lastname: Filez
authors.forename: Bernt
authors.initials: B
authors.lastname: Everts
authors.forename: William E
authors.initials: WE
authors.lastname: Waterfall
authors.forename: W
authors.initials: W
authors.lastname: Domschke
authors.forename: Stanislas
authors.initials: S
authors.lastname: Bruley des Varannes
authors.forename: Babajide O
authors.initials: BO
authors.lastname: Familoni
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Bourgeois
authors.forename: Jozef
authors.initials: J
authors.lastname: Janssens
authors.forename: Gervais
authors.initials: G
authors.lastname: Tougas
mesh_terms: D000293:Adolescent; D000328:Adult; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D004567:Electrodes, Implanted; D005240:Feasibility Studies; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000628:therapy; D004561:Transcutaneous Electric Nerve Stimulation; D014839:Vomiting / Q000628:therapy; D015430:Weight Gain