Gastric electrical stimulation for medically refractory gastroparesis

Thomas Abell, Richard W. McCallum, Michael Hocking, Kenneth Koch, Hasse Abrahamsson, Isabelle Leblanc, Greger Lindberg, Jan Konturek, Thomas Nowak, Eammon M.M. Quigley, Gervais Tougas, Warren Starkebaum

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393 Scopus citations

Abstract

Background & Aims: 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.

Original languageEnglish (US)
Pages (from-to)421-428
Number of pages8
JournalGastroenterology
Volume125
Issue number2
DOIs
StatePublished - Aug 1 2003

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ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Abell, T., McCallum, R. W., Hocking, M., Koch, K., Abrahamsson, H., Leblanc, I., Lindberg, G., Konturek, J., Nowak, T., Quigley, E. M. M., Tougas, G., & Starkebaum, W. (2003). Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology, 125(2), 421-428. https://doi.org/10.1016/S0016-5085(03)00878-3