title: Gastric electrical stimulation for medically refractory gastroparesis.
abstract: OBJECTIVE
  This study investigated the efficacy of gastric electrical stimulation for the treatment of symptomatic gastroparesis unresponsive to standard medical therapy.
  
  
  METHODS
  Thirty-three patients with chronic gastroparesis (17 diabetic and 16 idiopathic) received continuous high-frequency/low-energy gastric electrical stimulation via electrodes in the muscle wall of the antrum connected to a neurostimulator in an abdominal wall pocket. After implantation, patients were randomized in a double-blind crossover design to stimulation ON or OFF for 1-month periods. The blind was then broken, and all patients were programmed to stimulation ON and evaluated at 6 and 12 months. Outcome measures were vomiting frequency, preference for ON or OFF, upper gastrointestinal tract symptoms, quality of life, gastric emptying, and adverse events.
  
  
  RESULTS
  In the double-blind portion of the study, self-reported vomiting frequency was significantly reduced in the ON vs. OFF period (P < 0.05) and this symptomatic improvement was consistent with the significant patient preference (P < 0.05) for the ON vs. OFF period determined before breaking the blind. In the unblinded portion of the study, vomiting frequency decreased significantly (P < 0.05) at 6 and 12 months. Scores for symptom severity and quality of life significantly improved (P < 0.05) at 6 and 12 months, whereas gastric emptying was only modestly accelerated. Five patients had their gastric electrical stimulation system explanted or revised because of infection or other complications.
  
  
  CONCLUSIONS
  High-frequency/low-energy gastric electrical stimulation significantly decreased vomiting frequency and gastrointestinal symptoms and improved quality of life in patients with severe gastroparesis.
authors.affiliation: University of Mississippi, Jackson, Mississippi, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Abell
authors.forename: Richard
authors.initials: R
authors.lastname: McCallum
authors.forename: Michael
authors.initials: M
authors.lastname: Hocking
authors.forename: Kenneth
authors.initials: K
authors.lastname: Koch
authors.forename: Hasse
authors.initials: H
authors.lastname: Abrahamsson
authors.forename: Isabelle
authors.initials: I
authors.lastname: Leblanc
authors.forename: Greger
authors.initials: G
authors.lastname: Lindberg
authors.forename: Jan
authors.initials: J
authors.lastname: Konturek
authors.forename: Thomas
authors.initials: T
authors.lastname: Nowak
authors.forename: Eammon M M
authors.initials: EM
authors.lastname: Quigley
authors.forename: Gervais
authors.initials: G
authors.lastname: Tougas
authors.forename: Warren
authors.initials: W
authors.lastname: Starkebaum
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged