BACKGROUND: Application of electrical stimulation to the gut, primarily the stomach, has rapidly advanced in the last two decades, from mostly animal studies to the clinical arena. Most studies focused on the use of electrical stimulation for gastroparesis, the only approved indication for such intervention. AIM: To review the physiological basis of gastric electrical activity and the technical aspects and clinical outcome of gastric electrical stimulation (GES) for gastroparesis. METHODS: PubMed search from 1966 to 2009, using gastroparesis and GES as search terms. Areas in focus were systematically reviewed. RESULTS: The literature consists of open-label studies, mostly from single centres, published in the last decade. Improvement in symptoms, quality of life and nutritional status was reported by most studies. Physiologically, stimulation parameters approved in clinical practice do not regulate gastric slow wave activity and have inconsistent effect on gastric emptying. The mechanism of action of GES is not fully known, but data support modulation of gastric biomechanical activity and afferent neural mechanisms. CONCLUSIONS: Gastric electrical stimulation is a helpful intervention in recalcitrant gastroparesis. Controlled studies and better understanding of mechanisms of action of electrical stimulation are needed to evaluate further the clinical utility of this intervention and to exploit its therapeutic potential better.
BACKGROUND: Application of electrical stimulation to the gut, primarily the stomach, has rapidly advanced in the last two decades, from mostly animal studies to the clinical arena. Most studies focused on the use of electrical stimulation for gastroparesis, the only approved indication for such intervention. AIM: To review the physiological basis of gastric electrical activity and the technical aspects and clinical outcome of gastric electrical stimulation (GES) for gastroparesis. METHODS: PubMed search from 1966 to 2009, using gastroparesis and GES as search terms. Areas in focus were systematically reviewed. RESULTS: The literature consists of open-label studies, mostly from single centres, published in the last decade. Improvement in symptoms, quality of life and nutritional status was reported by most studies. Physiologically, stimulation parameters approved in clinical practice do not regulate gastric slow wave activity and have inconsistent effect on gastric emptying. The mechanism of action of GES is not fully known, but data support modulation of gastric biomechanical activity and afferent neural mechanisms. CONCLUSIONS: Gastric electrical stimulation is a helpful intervention in recalcitrant gastroparesis. Controlled studies and better understanding of mechanisms of action of electrical stimulation are needed to evaluate further the clinical utility of this intervention and to exploit its therapeutic potential better.
Authors: H P Parkman; M Camilleri; G Farrugia; R W McCallum; A E Bharucha; E A Mayer; J F Tack; R Spiller; M Horowitz; A I Vinik; J J Galligan; P J Pasricha; B Kuo; L A Szarka; L Marciani; K Jones; C R Parrish; P Sandroni; T Abell; T Ordog; W Hasler; K L Koch; K Sanders; N J Norton; F Hamilton Journal: Neurogastroenterol Motil Date: 2009-12-09 Impact factor: 3.598
Authors: Alison Smith; Robert Cacchione; Ed Miller; Lindsay McElmurray; Robert Allen; Abigail Stocker; Thomas L Abell; Michael G Hughes Journal: Am Surg Date: 2016-04 Impact factor: 0.688
Authors: Rui Wang; Zaid Abukhalaf; Amir Javan-Khoshkholgh; Tim H-H Wang; Shameer Sathar; Peng Du; Timothy R Angeli; Leo K Cheng; Greg O'Grady; Niranchan Paskaranandavadivel; Aydin Farajidavar Journal: IEEE J Emerg Sel Top Circuits Syst Date: 2018-03-05 Impact factor: 3.916
Authors: Thomas L Abell; Goro Yamada; Richard W McCallum; Mark L Van Natta; James Tonascia; Henry P Parkman; Kenneth L Koch; Irene Sarosiek; Gianrico Farrugia; Madhusudan Grover; William Hasler; Linda Nguyen; William Snape; Braden Kuo; Robert Shulman; Frank A Hamilton; Pankaj J Pasricha Journal: Neurogastroenterol Motil Date: 2019-10-04 Impact factor: 3.598