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Introduction: Gastric electrical stimulation has been used for over a decade for symptom control of gastroparesis refractory to medical treatment.
Objective: To evaluate long-term symptom control with gastric pacemaker therapy and the relationship to improvement in gastric emptying.
Methods: A retrospective review of symptom scores and gastric emptying nuclear scans of 117 patients at a single center from 2000 to 2011. The patients included in the study were 55 with diabetic gastroparesis, 55 with idiopathic gastroparesis, and 7 with post-surgical gastroparesis. Symptoms scores were compared for severity and frequency of nausea, vomiting, early satiety, and epigastric pain at pre-op, 6 months, 1 year, 3 years, and 5 years. Gastric emptying scan results from pre-op, 6 months, and 1 year were compared.
Results: Symptom scores for all patients were significantly improved at all follow-up intervals compared to pre-op (P<0.0001). Patients with idiopathic gastroparesis achieved the same degree of symptom control as diabetic patients. There was no significant change in gastric emptying from pre-op to 6 months or at 1 year post-op.
Conclusions: Symptoms for all patients significantly improved after initiation of gastric electrical stimulator therapy. The improvement continued for up to 5 years postoperatively. Patients with idiopathic gastroparesis had similar symptom improvement as those with diabetic gastroparesis. Despite symptom improvement, gastric emptying, as measured by nuclear scanning, was not significantly changed with gastric electrical stimulation. This observation suggests that gastric stimulation improves symptoms via a mechanism independent of the rate of gastric emptying.