title: Gastric electrical stimulation for abdominal pain in patients with symptoms of gastroparesis.
abstract: Abdominal pain physiology may be better understood studying electrophysiology, histology, and symptom scores in patients with the symptoms of gastroparesis (Gp) treated with gastric electrical stimulation (GES). Ninety-five Gp patients' symptoms were recorded at baseline and during temporary and permanent GES. Gastric-emptying times and cutaneous, mucosal, and serosal electrogastrograms were obtained. S100-stained, full-thickness gastric biopsies were compared with autopsy controls. Sixty-eight patients reported severe pain at baseline. Severe pain patients' mean pain scores decreased with temporary GES from 3.62 to 1.29 (P < 0.001) and nonsevere pain from 1.26 to 0.67 (P = 0.01). With permanent GES, severe mean pain scores fell to 2.30 (P < 0.001); nonsevere pain changed to 1.60 (P = 0.221). Mean follow-up was 275 days. Mean cutaneous, mucosal, and serosal frequencies and frequency-to-amplitude ratios were markedly higher than literature controls. For patients with Gp overall and subdivided by etiology and severity of pain, S-100 neuronal fibers were significantly reduced in both muscularis propria layers. GES improved severe pain associated with symptoms of Gp. This severe pain is associated with abnormal electrogastrographic activity and loss of S100 neuronal fibers in the stomach's inner and outer muscularis propria and, therefore, could be the result of gastric neuropathy.
authors: Department of Surgery, School of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA. chrislahr@aol.com
authors: Christopher J
authors: CJ
authors: Lahr
authors: James
authors: J
authors: Griffith
authors: Charu
authors: C
authors: Subramony
authors: Lindsey
authors: L
authors: Halley
authors: Kristen
authors: K
authors: Adams
authors: Elizabeth R
authors: ER
authors: Paine
authors: Robert
authors: R
authors: Schmieg
authors: Saleem
authors: S
authors: Islam
authors: Jay
authors: J
authors: Salameh
authors: Danielle
authors: D
authors: Spree
authors: Truptesh
authors: T
authors: Kothari
authors: Archana
authors: A
authors: Kedar
authors: Yana
authors: Y
authors: Nikitina
authors: Thomas
authors: T
authors: Abell
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology; D005753:Gastric Mucosa / Q000473:pathology / Q000503:physiopathology; D018589:Gastroparesis / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000378:metabolism / Q000473:pathology; D010147:Pain Measurement; D009418:S100 Proteins / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D009418:S100 Proteins
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