Gastric electrical stimulation increases the discomfort threshold to gastric distension.
BACKGROUND
Gastric electrical stimulation (GES) is now considered as a new therapeutic alternative for patients with medically refractory vomiting and/or nausea, although its mechanisms of action remain poorly understood.


METHODS
Gastric discomfort threshold, measured as the gastric maximal tolerable volume (MTV) to distension, was examined before and after GES, in nine patients implanted for chronic and severe nausea and vomiting.


RESULTS
GES increased gastric MTV from 522 ± 64 ml at baseline to 628 ± 60 ml 6 months after the start of GES (P=0.03), whereas gastric emptying remained unchanged. The increase in MTV was correlated with symptoms and quality of life at 6 months, whereas gastric emptying was not. Finally, MTV varied in a similar manner at 6 months in patients with delayed and normal gastric emptying measured before implantation.


CONCLUSIONS
Taken together, these data indicate that modification of gastric sensation to distension, rather than gastric emptying, is associated with symptoms' outcome during GES.
Nutrition, Gut & Brain Unit, INSERM UMR 1073, Institute for Biomedical Research and Innovation, Rouen University, Rouen, France. guillaume.gourcerol@chu-rouen.fr
Guillaume
G
Gourcerol
Wassila
W
Ouelaa
Emmanuel
E
Huet
Anne M
AM
Leroi
Philippe
P
Ducrotte
D000328:Adult; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D018589:Gastroparesis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D017288:Pain Threshold / Q000502:physiology*; D011788:Quality of Life; D012684:Sensory Thresholds / Q000502:physiology; D013314:Stress, Mechanical; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*