Gastric electrical stimulation – Our experience in Cork University Hospital

Aims: Gastroparesis refractory to prokinetics poses a major challenge to the gastroenterologist. Gastric electrical stimulation (GES) is being increasingly used worldwide in this situation, but despite encouraging clinical trials, had never been tried in Ireland. We describe our experience with gastric neurostimulators.

Methods: Patient 1 was a 23 year old male with type 1 Diabetes Mellitus for 16 years. He had repeated admissions since 2000 with intractable vomiting secondary to gastroparesis unresponsive to prokinetic agents. Patient 2 was a 60 year old diabetic female with recurrent admissions with severe gastroparesis over the last 2 years.

The GES (High frequency, Enterra therapy, Medtronic) leads were implanted to the gastric wall by a surgeon, with the stimulator lying subcutaneously.

Results: After 6 months, both patients reported improvement in symptoms and quality of life, as assessed by a diary. Daily episodes of nausea and vomiting were markedly reduced. Hospital readmissions did not appear however to be majorly affected.

Conclusion: Our experience with GES is encouraging. Studies have shown that 75% of diabetic gastroparetics can expect improvement in weekly vomiting frequency and quality of life. Refinements in GES technology and further experience should pave the way for more widespread use of this electrical therapy of gastroparesis refractory to prokinetics.