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75 IS CHRONIC HIGH-FREQUENCY GASTRIC ELECTRICAL STIMULATION EFFECTIVE IN PATIENTS WITH CHRONIC FUNCTIONAL NAUSEA AND VOMITING AND A NORMAL GASTRIC EMPTYING?
  1. Z. Lin,
  2. I. Sarosiek,
  3. J. Forster,
  4. R. W. McCallum
  1. University of Kansas Medical Center, Kansas City, KS

Abstract

The aim of this study was to investigate the effectiveness of high-frequency gastric electrical stimulation (GES, Enterra Therapy) in patients with symptoms suggestive of gastroparesis but who had a normal gastric emptying and were given the diagnosis of functional nausea and vomiting.

Methods This study included 11 such patients (3 M, 8 F, median age 41 years, range 21-53, 4 diabetic and 7 idiopathic) who had a documented normal baseline gastric emptying test (GET) (normal value at 4 hours < 10% gastric retention) and received GES therapy for at least 1 year. Patient characteristics, total symptom score (TSS) derived from 7 upper gastrointestinal symptom subscores (0-4), and 4-hour standardized GET using a low-fat egg meal were evaluated at baseline and at 1 year of GES, which was implanted and programmed according to our previous publications in gastroparesis patients (Am J Surg 2001;182:676-81). Data are presented as median (range). Results of 2-hour and 4-hour gastric retention (%) and nausea, vomiting scores and TSS and weight at baseline and 1 year of GES are summarized in the table below. Overall there was no significant change in gastric emptying and approximately 67% patients continued to have a normal GET after 1 year of GES. However, one-third of patients did develop a slowing of GET (> 10% retention at 4 hours). Symptom severity of nausea, vomiting, and TSS were significantly improved. Sixty-four percent of patients had $ 50% reduction in TSS and the median reduction of TSS was 51%. Patients overall maintained their weight during the GES therapy.

Conclusions In patients with functional nausea and vomiting and a normal GET high-frequency GES is effective in improving nausea, vomiting, and related symptoms as well as maintaining nutrition.

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