Gastricelectricstimulationforrefractory gastroparesis

Bryan Zoll, Asad Jehangir, Zubair Malik, Michael A. Edwards, Roman V. Petrov, Henry P. Parkman

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Objective: To outline the use and utility of gastric electric stimulation (GES) as a therapeutic intervention for gastroparesis. Methods: Review of the literature. Results: Gastroparesis is characterized by delayed gastric emptying, with symptoms of nausea, vomiting, early satiety, postprandial fullness, and abdominal pain. Some patients with gastroparesis do not respond to medical intervention, and for these patients surgical intervention may be warranted. GES utilizes high-frequency gastric neurostimulation to facilitate gastric emptying and reduce symptoms of gastroparesis. It is indicated for patients with idiopathic and diabetic gastroparesis who have nausea and vomiting as their primary symptoms and who have not responded to medical therapy. GES has also been used in postsurgical and pediatric gastroparesis patients. Optimizing the outcome of this surgical treatment through proper patient selection and meticulous surgical technique is essential as there are inherent risks to the procedure. Nonblinded studies of GES for medically refractory gastroparesis have demonstrated therapeutic symptomatic benefit, whereas randomized controlled trials have not. New interventions such as pyloromyotomy and pyloroplasty are reasonable alternatives or addendums to GES. Conclusion: GES may be considered among the therapies available for treating patients with refractory symptoms of gastroparesis. More studies, specifically those comparing GES, pyloromyotomy, GES combined with pyloromyotomy, and placebo, are needed to help guide therapy selection for refractory gastroparesis.

Original languageEnglish (US)
Pages (from-to)27-38
Number of pages12
JournalJournal of Clinical Outcomes Management
Volume26
Issue number1
StatePublished - Jan 2019
Externally publishedYes

Keywords

  • Diabetes
  • Dysmotility
  • Electric stimulation
  • Gastric emptying
  • Gastroparesis

ASJC Scopus subject areas

  • Health Policy

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