title: A slow caloric satiety drinking test in patients with temporary and permanent gastric electrical stimulation.
abstract: OBJECTIVE
  Improvement of gastric accommodation has been proposed as a potential explanation for the positive effect of gastric electrical stimulation (GES) on nausea/vomiting. A drinking test has been suggested as a noninvasive measure of gastric accommodation capacity.
  
  
  METHODS
  Eight patients with therapy refractory nausea and vomiting and nonapproved diagnosis for GES (chronic intestinal pseudo-obstruction (CIP, n=1), functional dyspepsia (FD, n=3), postsurgical gastroparesis (PSGP, n=4) underwent temporary percutaneous GES for 10-14 days, randomized to stimulation ON or OFF, respectively. 19 patients [CIP (n=1), diabetic gastroparesis (n=5), FD (n=5), idiopathic gastroparesis (n=4), PSGP (n=4)] received permanent GES (Enterra, Medtronic) (follow-up at baseline, 6 and 12 months). At the end of each stimulation period a slow caloric satiety drinking test was performed (Nutridrink 1.5 kcal/ml, 15 ml/min).
  
  
  RESULTS
  Healthy volunteers had higher drinking capacity compared to patients at baseline (1630 + or - 496 kcal vs. 887 + or - 412; P<0.001) and less composite symptom score (128 + or - 51 vs. 235 + or - 83; P<0.001). With temporary percutaneous GES, there was no significant change in drinking capacity during stimulation ON versus OFF (746 + or - 383 vs. 734 + or - 427 kcal) and symptom severity at the drinking test was unchanged. For patients having permanent GES there was no significant difference at 6 months (876 + or - 277 kcal) versus baseline, and no difference between symptomatic responders and nonresponders in change in drinking capacity (P=0.7).
  
  
  CONCLUSIONS
  GES had no effect on proximal gastric function as evaluated by the slow caloric satiety drinking test. This seems to be the case for patients with approved as well as nonapproved indications for GES, and irrespective of the symptomatic response.
authors.affiliation: Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden. stina.anna.andersson@vgregion.se
authors.forename: Stina
authors.initials: S
authors.lastname: Andersson
authors.forename: Anders
authors.initials: A
authors.lastname: Elfvin
authors.forename: Gisela
authors.initials: G
authors.lastname: Ringström
authors.forename: Hans
authors.initials: H
authors.lastname: Lönroth
authors.forename: Hasse
authors.initials: H
authors.lastname: Abrahamsson
authors.forename: Magnus
authors.initials: M
authors.lastname: Simrén
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D048909:Diabetes Complications / Q000628:therapy; D004326:Drinking; D004415:Dyspepsia / Q000628:therapy; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D005746:Gastric Emptying; D005767:Gastrointestinal Diseases / Q000503:physiopathology* / Q000628:therapy*; D018589:Gastroparesis / Q000628:therapy; D006801:Humans; D007418:Intestinal Pseudo-Obstruction / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000628:therapy; D012528:Satiety Response; D013270:Stomach / Q000503:physiopathology; D016896:Treatment Outcome; D014839:Vomiting / Q000628:therapy; D055815:Young Adult