title: Treating an oft-unrecognized and troublesome entity: using gastric electrical stimulation to reduce symptoms of malignancy-associated gastroparesis.
abstract: Malignancy-associated gastroparesis (MAG) is a cause of morbidity in cancer patients but therapies are lacking. Gastric electrical stimulation (GES) is a novel treatment for MAG. Here, we describe 19 patients with MAG who underwent temporary GES placement.
  
  
  
  Nineteen patients (6 males, 13 females) with various malignancies were reviewed for symptom scores and physiologic measures at baseline and after temporary GES placement. Symptoms were scored by three variables: nausea (N), vomiting (V), and GI total symptom score (TSS). Physiologic profiles were measured by solid and liquid phase gastric emptying scans (GET) at 1, 2, and 4 h and cutaneous electrogastrogram (EGG) and mucosal electrogram (EG) frequencies. Symptoms were measured for 5 days after temporary endoscopic GES placement, and measures were repeated post GES placement.
  
  
  
  Baseline GET results displayed delayed gastric emptying in 16 of 19 patients (mean solid retention 21.7 % at 4 h, normal <10 %; mean liquid retention 10.4 % at 4 h, normal <5 %). Cutaneous EGG (mean frequency 5.5 cpm) and EG (mean proximal frequency 5.1 cpm; mean distal frequency 5.1 cpm) showed evidence of neuromuscular dysfunction (normal 2.5-3.3 cpm). Symptom scores in N, V, and TSS showed statistically significant reduction after GES placement.
  
  
  
  A small sample of patients with MAG and receiving temporary GES experienced symptom improvement, with less change on gastric emptying time or gastric electrical amplitude or frequency. GES may provide a potential therapeutic option for symptomatic management of MAG and evaluation of these MAG patients after permanent GES placement is ongoing. Prospective studies of MAG using temporary and permanent GES may be warranted.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Hamza
authors.initials: H
authors.lastname: Shah
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Gregg
authors.initials: G
authors.lastname: Wendorf
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Shifat
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Lindsay
authors.initials: L
authors.lastname: McElmurray
authors.affiliation: University of Mississippi, Jackson, MS, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Lahr
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Hughes
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Beauerle
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Ed
authors.initials: E
authors.lastname: Miller
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA.
authors.forename: Abigail
authors.initials: A
authors.lastname: Stocker
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, 550 S Jackson Street, ACB3 A3L15, Louisville, KY, 40202, USA. thomas.abell@louisville.edu.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Abell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D018589:Gastroparesis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000706:statistics & numerical data*
keywords: ᅟ