Gastric Electrical Stimulation Reduces Refractory Vomiting in a Randomized Crossover Trial

Ducrotté, Philippe; Coffin, Benoït; Bonaz, Bruno; Fontaine, Sébastien; Varannes, Stanislas Bruley des; Zerbib, Frank; Caïazzo, Robert; Grimaud, J. C.; Mion, François; Hadjadj, Samy; Valensi, P.; Vuitton, Lucine; Charpentier, G.; Ropert, Alain; Altwegg, Romain; Pouderoux, Philippe; Dorval, Étienne; Dapoigny, Michel; Duboc, Henri; Benhamou, Pierre Yves; Schmidt, Aurélie; Donnadieu, N.; Gourcerol, Guillaume; Guerci, Bruno; Leroi, Anne Marie; Prévost, Gaëtan; Huet, Emmanuel; Robert, M.; Disse, Emmanuel; Denost, Quentin; Castel, Benjamin; Calabrese, Daniela; Borot, Sophie; Mathieu, Pierre; Letessier, E; Vavasseur, Fabienne; Reche, Fabián; Mathieu, Nicolas; Borie, F.; Penfornis, A.; Hanaire, H.; Jeandidier, N.; Fontaine, P.

doi:10.1053/j.gastro.2019.10.018

Cited by 113 publications

(83 citation statements)

References 34 publications

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“…Gastric electrical stimulation has been used for adults with nausea and vomiting refractory to conventional treatment for over two decades and in children for over the past decade [36]. The literature supporting its use in adults has been growing over time, most recently after a randomized controlled trial of 172 patients treated with gastric electrical stimulation demonstrated significantly improved vomiting scores when the stimulator was on compared to off [37]. Gastric electrical stimulation appeared to have several early and late physiological effects, but its beneficial effect on gastric emptying was not consistent.…”

Section: Gastric Electrical Stimulationmentioning

confidence: 99%

Gastroparesis in the Pediatric Patient: Children Are Not Little Adults

Lorenzo

2020

Gastrointestinal Disorders

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Although the definition of gastroparesis in children is the same as in adults, there are key differences between gastroparesis in these two populations in presentation, diagnosis, treatment and outcomes. Infants and younger children with gastroparesis tend to be male, present with vomiting as their primary symptom and are more likely to experience the resolution of their symptoms over time. Adolescents with gastroparesis tend to be female, present with abdominal pain as their primary symptom and have a less favorable short- and medium-term outcome, sharing some similarities with adults with gastroparesis. Despite the fact that validated diagnostic criteria for gastroparesis are lacking in infants and younger children, these age groups make up nearly half of children with gastroparesis in some studies. The diagnosis and treatment of children with gastroparesis has thus far relied heavily on research studies performed in adults, but it is becoming increasingly clear that gastroparesis in children is a distinct entity and there are limitations to the applicability of data obtained from adults to the care of children.

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Section: Gastric Electrical Stimulationmentioning

confidence: 99%

Gastroparesis in the Pediatric Patient: Children Are Not Little Adults

Lorenzo

2020

Gastrointestinal Disorders

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“…This explains the symptom relief provided by GES, an anti-emetic prescription for gastroparetics when there is no improvement with other standard medical therapies. Although many studies have demonstrated that GES has significantly improved symptoms associated with gastroparesis [43,50], it has not been shown to significantly change gastric emptying rates. A recent large, multicenter, randomized, double-blind cross-over study by Ducrotte et al of 172 patients (72 diabetic) with chronic (>12 months) drug-refractory vomiting reported a significant reduction in vomiting frequency after GES therapy for four months in both nondiabetic and diabetic patients [51].…”

Section: Gastrointest Disord 2020 2 For Peer Reviewmentioning

confidence: 99%

Status of Brain Imaging in Gastroparesis

Gonzalez

McCallum

2020

Gastrointestinal Disorders

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The pathophysiology of nausea and vomiting in gastroparesis is complicated and multifaceted involving the collaboration of both the peripheral and central nervous systems. Most treatment strategies and studies performed in gastroparesis have focused largely on the peripheral effects of this disease, while our understanding of the central nervous system mechanisms of nausea in this entity is still evolving. The ability to view the brain with different neuroimaging techniques has enabled significant advances in our understanding of the central emetic reflex response. However, not enough studies have been performed to further explore the brain–gut mechanisms involved in nausea and vomiting in patients with gastroparesis. The purpose of this review article is to assess the current status of brain imaging and summarize the theories about our present understanding on the central mechanisms involved in nausea and vomiting (N/V) in patients with gastroparesis. Gaining a better understanding of the complex brain circuits involved in the pathogenesis of gastroparesis will allow for the development of better antiemetic prophylactic and treatment strategies.

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“…5,6 Adding to the controversy was the observation that the studies enrolled patients with gastroparesis, but that gastric emptying rate did not improve with GES. [3][4][5][6] In this issue of Gastroenterology, Ducrotte et al 7 report the outcomes of a large, high-quality, multicenter controlled trial with GES for chronic refractory vomiting, designed to address these concerns. A GES device was implanted in 172 patients, of which 72 were diabetics.…”

mentioning

confidence: 99%

“…In addition, although patients had suffered an average weight loss of 12 kg since the onset of symptoms, no change in nutritional parameters was associated with GES treatment. 7 Some adverse events were also associated with GES treatment, such as pain in 26 or infection at the insertion site in 16 patients, and in 3 patients the device needed to be removed. 7 Unlike previous studies, this GES controlled trial did not select patients with gastroparesis, but enrolled patients with drug-refractory vomiting.…”

mentioning

confidence: 99%

“…7 Some adverse events were also associated with GES treatment, such as pain in 26 or infection at the insertion site in 16 patients, and in 3 patients the device needed to be removed. 7 Unlike previous studies, this GES controlled trial did not select patients with gastroparesis, but enrolled patients with drug-refractory vomiting. All patients had a gastric emptying test at baseline, which revealed delayed gastric emptying in 79%.…”

mentioning

confidence: 99%

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