Gastroparesis syndromes: Response to electrical stimulation.
Authors Abell TL, Kedar A, Stocker A, Beatty K, McElmurray L, Hughes M, Rashed H,
Kennedy W, Wendelschafer-Crabb G, Yang X, Fraig M, Omer E, Miller E, Griswold M,
Pinkston C
Submitted By Submitted Externally on 2/4/2019
Status Published
Journal Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
Year 2019
Date Published 1/1/2019
Volume : Pages Not Specified : e13534
PubMed Reference 30706646
Abstract Factors underlying gastroparesis are not well defined, nor is the mechanism of
action of gastric electrical stimulation (GES). We hypothesized that GES acts
via several mechanisms related to underlying disordered pathophysiology., We
studied 43 consecutive eligible patients with gastroparetic symptoms, previously
evaluated by two methods in each of five core areas: inflammatory, autonomic,
enteric, electrophysiologic, and hormonal; and also categorized by GI symptoms,
metabolic status, illness quantification, and gastric physiology. We then
studied 41 patients who underwent temporary GES for 5-7 days. Thirty-six of
those patients were implanted and 30 were followed up at 6 months after
permanent GES., In previous but separately reported work, patients had similar
GI symptoms regardless of baseline gastric emptying or diabetic/idiopathic
status and all patients demonstrated abnormalities in each of the five areas
studied. After GES, patients showed early and late effects of electrical
stimulation with changes noted in multiple areas, categorized by improvement
status., Patients with symptoms of gastroparesis have multiple abnormalities,
including systemic inflammation and disordered hormonal status. GES affects many
of these abnormalities. We conclude electrical stimulation improves symptoms and
physiology with (a) an early and sustained anti-emetic effect; (b) an early and
durable gastric prokinetic effect in delayed emptying patients; (c) an early
anti-arrhythmic effect that continues over time; (d) a late autonomic effect;
(e) a late hormonal effect; (f) an early anti-inflammatory effect that persists;
and (g) an early and sustained improvement in health-related quality of life.
This study is registered with Clinicaltrials.gov under study # NCT03178370
(https://clinicaltrials.gov/ct2/show/NCT03178370).

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