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Gastric Electric Stimulation Benefited Patients with Refractory Gastroparesis
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PHILADELPHIA — Gastric electric stimulation reduced symptoms in patients with refractory gastroparesis, according to data presented at the ACG Annual Scientific Meeting.
“Gastric electric stimulation has been investigated as a treatment for patients with refractory gastroparesis,” Jason Heckert, a student at Temple University School of Medicine, said in a presentation. “Enterra therapy (Medtronic) uses an implantable, programmable neurostimulator with placement of stimulation wires into the greater curvature of the stomach to deliver high-frequency, low-energy stimulation.”
To determine the effectiveness of gastric electric stimulation for treating refractory symptoms of gastroparesis in clinical practice, as well as clinical factors that affect outcomes, and specific symptoms that improve with therapy, Heckert and colleagues performed a prospective, single-center analysis of 151 patients (mean age, 38.2 years; 120 women, 72 diabetic).
All patients had a gastric electric stimulator inserted between July 2010 and November 2013 and were followed up for 6 months, throughout which their symptoms were assessed by questionnaire and response by Clinical Patient Grading Assessment Scale (CPGAS).
Of 138 patients who completed follow-up, 104 improved, 60 of whom had significant improvement and 34 felt the same or worse. Mean CGPAS scores were 2.4 overall; 3.5 in patients with diabetes vs. 1.5 in idiopathic patients (P<.05); and 2.4 in patients whose main symptoms were nausea and vomiting vs. 2 in patients whose main symptom was abdominal pain (P>.1). Symptoms with the greatest reduction included loss of appetite (34%), nausea (30%), retching (27%) and upper abdominal pain (26%).
“In conclusion, gastric electric stimulation was beneficial to the majority of patients in this study; 75% of patients improved, with 43% having marked clinical improvement,” Heckert said. “Diabetic patients showed a better overall response with higher mean CPGAS scores and more marked improvement than idiopathic patients, and finally, gastric stimulation provides a reduction in gastroparesis symptoms.”
For more information:
Heckert J. Abstract 67. Presented at: ACG Annual Scientific Meeting, Oct. 20-22, 2014; Philadelphia.
Disclosure: Relevant financial disclosures were not provided.