This review is the proceeding of a symposium on gut electrical stimulation held at the 16th International Workshop on Electrogastrography, sponsored by the International Electrogastrography Society, in San Diego, in May 2008.
Review article: gastric electrical stimulation for gastroparesis – physiological foundations, technical aspects and clinical implications
Article first published online: 2 JUL 2009
© 2009 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 30, Issue 7, pages 681–694, October 2009
How to Cite
SOFFER, E., ABELL, T., LIN, Z., LORINCZ, A., MCCALLUM, R., PARKMAN, H., POLICKER, S. and ORDOG, T. (2009), Review article: gastric electrical stimulation for gastroparesis – physiological foundations, technical aspects and clinical implications. Alimentary Pharmacology & Therapeutics, 30: 681–694. doi: 10.1111/j.1365-2036.2009.04082.x
- Issue published online: 3 SEP 2009
- Article first published online: 2 JUL 2009
- Publication data Submitted 15 May 2009 First decision 14 June 2009 Resubmitted 29 June 2009 Accepted 30 June 2009 Epub Accepted Article 2 July 2009
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.