Outcomes of High-Frequency Gastric Electric Stimulation for the Treatment of Severe, Medically Refractory Gastroparesis in Finland

Laine, Mika; Sirén, Jan; Koskenpato, Jari; Punkkinen, Jari; Rantanen, Tuomo; Typpö, I.; Kokkola, Arto; Sallinen, Ville

doi:10.1177/1457496917748222

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…After the pacemaker implantation procedure, eight patients reported significant relief of these symptoms, and three said partial replacement. One patient did not report any improvement in nausea/vomiting but had substantial weight gain [ 21 ].…”

Section: Reviewmentioning

confidence: 99%

“…A retrospective multi-center cohort study with 13 patients implanted with GES also supported the benefit of using GES for patients suffering from weight loss due to gastroparesis. According to this study, 11 patients (79%) gained a median of 5.1 kg in weight (P < 0.01) [ 21 ]. Another study with positive results is a retrospective single-center study with 50 participants showing improved BMI post gastric pacemaker implantation (23.40 vs. 26.46, p= 0.048) [ 15 ].…”

Section: Reviewmentioning

confidence: 99%

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A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis

Rajamanuri

Mannava

Chhabra

et al. 2021

Cureus

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Gastroparesis or gastric stasis is the delayed transit of the ingested contents through the stomach in the absence of mechanical obstruction. It can have multiple etiologies, most commonly idiopathic (ID) and diabetic (DM). Gastroparesis can cause significant distress to patients as it leads to symptoms like intractable nausea and vomiting, weight loss, abdominal bloating, early satiety, etc. The pathogenesis is mainly thought to be due to the dysfunction of the gastric pacemaker cells, i.e., interstitial cells of Cajal (ICC), and their interaction with the other gastric motor function regulatory components. There are several proposed treatment options for gastroparesis. Despite that, most patients remain refractory to medical treatment and require additional interventions for symptomatic relief. One such intervention is gastric electrical stimulation or gastric pacemaker, which aids in improving gastric motility. We have searched PubMed, PubMed Central (PMC), Medline, Science Direct, and Google Scholar for articles pertaining to the use of gastric electrical stimulation in gastroparesis published in the last 10 years. The keywords used include "gastroparesis", "gastric stasis", "gastric pacemaker'', "gastric electrical stimulation", "nausea", "vomiting", "abdominal bloating", "gastric neuromodulation". We have finally included twelve studies that were the most relevant to our research question and met the quality assessment criteria. Exclusion criteria consisted of pediatric population studies, studies conducted on animals, books, and grey literature. Overall, these twelve studies helped evaluate the impact of gastric pacemakers on symptoms of gastroparesis like nausea, vomiting, weight loss, abdominal bloating, and quality of life. We found that most studies favored gastric pacemakers, improving the incidence of nausea and vomiting in patients with gastroparesis. There was a marked improvement in the BMI as well. On the other hand, most open-labeled studies showed improved quality of life and Gastroparesis Cardinal Symptom Index (GCSI) scores, while randomized controlled trials and meta-analyses did not reflect the same result. In addition, some other parameters improved with gastric pacemakers, Inflammatory markers, insulin levels (especially in diabetics), and the number of hospitalizations. In conclusion, gastric pacemaker is a potential treatment option for patients with medically refractory gastroparesis. As noted from the results of our study, nausea/vomiting, weight loss, and overall GCSI scores have shown marked improvement with gastric electrical stimulation (GES). Nevertheless, more extensive research is needed to understand better the full extent of this device’s use as a viable treatment option for patients suffering from gastroparesis.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis

Rajamanuri

Mannava

Chhabra

et al. 2021

Cureus

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“…They have been shown to improve symptoms 58 and, to a lesser extent, gastric emptying predominately in diabetic patients. 12 Reduction in the need for enteral feeding in refractory patients is common following device insertion 59,60 but the underlying mechanism remains unclear in the context of the small improvements in gastric emptying. Laine et al 59 highlight four patients in their study who had relapse of symptoms after their batteries were depleted, and remission after replacement.…”

Section: Gastric Electrical Stimulatorsmentioning

confidence: 99%

“…12 Reduction in the need for enteral feeding in refractory patients is common following device insertion 59,60 but the underlying mechanism remains unclear in the context of the small improvements in gastric emptying. Laine et al 59 highlight four patients in their study who had relapse of symptoms after their batteries were depleted, and remission after replacement. Long-term follow up has shown durable results, 61 but the serious complication rate was high, with 9% developing device infections requiring removal.…”

Section: Gastric Electrical Stimulatorsmentioning

confidence: 99%

Practical management approach to gastroparesis

Longley

2020

Internal Medicine Journal

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Gastroparesis is a syndrome characterised by delayed gastric emptying in the absence of mechanical obstruction. Symptoms can include early satiety, abdominal pain, bloating, vomiting and regurgitation which cause significant morbidity in addition to nutritional deficits. There is a higher prevalence in diabetics and females, but the incidence in the Australian population has not been well studied. Management of gastroparesis involves investigating and correcting nutritional deficits, optimising glycaemic control and improving gastrointestinal motility. Symptom control in gastroparesis can be challenging. Nutritional deficits should be addressed initially through dietary modification. Enteral feeding is a second‐line option when oral intake is insufficient. Home parenteral nutrition is rarely used, and only accessible through specialised clinics in the outpatient setting. Prokinetic medication classes that have been used include dopamine receptor antagonists, motilin receptor agonists, 5‐HT4 receptor agonists and ghrelin receptor agonists. Anti‐emetic agents are often used for symptom control. Interventional treatments include gastric electrical stimulation, gastric per‐oral endoscopic myotomy, feeding jejunostomy and gastrostomy/jejunstomy for gastric venting and enteral feeding. In this article we propose a framework to manage gastroparesis in Australia based on current evidence and available therapies.

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New Approaches to Diagnosis and Treatment of Functional Dyspepsia

Tomita

Oshima

Miwa

2018

Curr Gastroenterol Rep

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Outcomes of High-Frequency Gastric Electric Stimulation for the Treatment of Severe, Medically Refractory Gastroparesis in Finland

Abstract: Gastric electrical stimulator seems to improve the nutritional status and give clear relief of the symptoms of severe, medically uncontrollable gastroparesis. Given the low number of operations, gastric electrical stimulator seems to be underused in Finland.

Cited by 4 publications

References 24 publications

A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis

A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis

Practical management approach to gastroparesis

New Approaches to Diagnosis and Treatment of Functional Dyspepsia

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