Health Problem: Normal gastric emptying involves a coordinated set of muscular contractions that are controlled by enteric neurons, smooth muscle cells, and the autonomic nervous system. Delayed gastric emptying due to gastroparesis can cause nausea, vomiting, early satiety, distension/bloating, and epigastric pain. Inadequate control of these symptoms can result in dehydration, weight loss, and malnutrition.
Technology Description: Gastric electrical stimulation (GES) is a treatment for patients who have chronic gastroparesis. GES involves implantation of an Enterra stimulator (Medtronic Inc.) that delivers electrical impulses to the gastric muscles to stimulate gastric myoelectric activity, which improves stomach emptying and reduces the frequency and severity of symptoms.
Controversy: GES has not been rigorously evaluated; some patients do not respond to it, and it is difficult to predict which patients will find it beneficial.
Key Questions:
- Does permanent GES reduce gastroparesis symptom frequency and/or severity in patients with gastroparesis?
- Does permanent GES improve gastric emptying?
- Does permanent GES improve health-related quality of life (QOL), survival, nutritional status, and body weight?
- Is GES safe?
- Have definitive patient selection criteria been identified for the use of GES for treatment of gastroparesis?
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