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Gastrointestinal electrical stimulation in post‐surgical gastroparesis improves symptoms independently while gastric emptying response is dependent on baseline emptying
Author(s) -
SCHMIEG RE,
MINOCHA A,
ABIDI N,
ABELL TL
Publication year - 2006
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/j.1365-2982.2006.00789_39.x
Subject(s) - gastric emptying , gastroparesis , medicine , gastroenterology , vomiting , meal , stimulation , stomach
Temporary GES (tempGES) can improve both gastric emptying and symptoms in post‐surgical gastroparesis (PS‐GP). (SSAT 2004). Long‐term effects on GI symptoms and gastric emptying are unknown. Since many PS‐GP patients have non‐delayed emptying, the long‐term effect on baseline normal or rapid emptying is also unknown. Patients: 36 pts (6 M, 30 F, mean age 42 years) with post‐surgical: Bilroth I ( n = 11), Bilroth II ( n = 4), other gastric surgery ( n = 21) disordered gastric emptying were evaluated. Methods: GI symptoms (vomiting = V, Total = TSS), and solid meal gastric emptying (GET) at 1 and 4 h, were compared at baseline (Base), after temporary (tempGES) and permanent (permGES) gastric electrical stimulation as previously described (NGM, 2004; 16: 635.) Long‐term follow‐up for permanent GES ranged from 6 month to 10 years. Results were compared by t‐tests, and are reported as means ± SEM. Results: 29 of the 36 patients were able to tolerate food for baseline quantitative gastric emptying testing. 20 patients had delayed and 9 patients had non‐delayed gastric emptying, with 7/9 being rapid. With both tempGES and permGES, GI symptoms improved (p < 0.05). Both tempGES and permGES showed accelerated GET for delayed patients and generally slowed GET for non‐delayed (p < 0.05 for 1 h values). See tables below. Conclusions: In a large group of post‐surgical GP patients, temporary and permanent gastrointestinal electrical stimulation improved GI symptoms independent of gastric emptying and for a prolonged time. GES improves symptoms independent of baseline gastric emptying, and improves GET dependent on the baseline gastric emptying.Groups All Delayed Non‐delayedN = 36 N = 20 N = 9V TSS V TSS V TSS Base 3.5 ± 0.7 15.6 ± 0.5 3.2 ± 0.2 16.0 ± 0.6 4.6 ± 2.9 15.7 ± 1.0 Temp 0.8 ± 0.3 6.1 ± 1.2 0.9 ± 0.4 5.4 ± 1.7 1.0 ± 0.8 7.9 ± 3.5 Perm 1.2 ± 0.3 9.3 ± 1.2 0.8 ± 0.3 7.6 ± 1.3 1.8 ± 0.4 10.3 ± 3.9