Gastric electrical stimulation (GES) has long been suggested as a treatment for symptoms of gastroparesis, but the use of the technique has been deemed controversial. A recent study published in the Neurogastroenterology & Motility journal may help to put an end to the controversy, however. The multicenter study found that GES actually is beneficial when it comes to improving symptoms for patients suffering from gastroparesis, especially for those who experience severe symptoms. The results of the study were significant enough that moving forward, it may change the way that gastroparesis symptoms are treated in many patients.
GES Device Usage
Though they have been approved as a Humanitarian Use Device (HUD) in the United States since 2000, the use of GES devices has been limited. This is not to say that the devices have not been used during that time; thousands of patients with gastroparesis of either diabetic or idiopathic origin have been treated with GES devices. There has been a significant amount of debate as to whether the devices are actually effective, however, and even controlled trials of these devices have been a source of controversy. Due to the fact that the devices apply electrical stimulation to human subjects, many have been hesitant to use them if there is any doubt as to their effectiveness.
The recently published study was published by Thomas L. Abell of the University of Louisville and his colleagues. The study tracked 319 patients who suffered from either idiopathic or diabetic gastroparesis symptoms who had participated in Gastroparesis Clinical Research Consortium (GpCRC) observational studies. Of these participants, 238 did not receive gastric electrical stimulation over the course of the study; the remaining 81 patients did receive GES. Tracking the effects of GES by examining the GCSI total score and nausea/vomiting subscales over the course of 48 weeks, the researchers found significant improvements in those who used GES devices.
There were several notable findings unearthed in the study. While those patients who underwent GES were in clinically worse condition than patients who did not receive GES, improvements for patients with GES were higher than non-GES by greater than one point. They also saw greater improvements regarding change from the time of enrollment. Nausea symptom scores also improved more for patients with GES, and those patients who had worse total scores saw greater improvements than those who did not. Even when accounting for imbalances in scores that might be affected by the characteristics of individual patients, only nausea remained significant as a symptom and even that saw notable improvement.
It is worth noting that this study is only a starting point for future research into the more widespread use of gastric electrical stimulation in patients with gastroparesis. Additional studies with a much larger number of patients will be needed in order to fully evaluate it as an effective therapy option, though this was one of the largest studies of its kind that has been performed to date. Building off the work that was done in this study, future research can examine the specifics of symptomatic responses to GES and which symptoms are most likely to benefit from the treatment. Future studies may also isolate trends among patients and make it easier for medical providers to identify patients who are most likely to respond to GES treatment.
By Jack Gerard from In The Cloud Copy