Gastric electrical stimulation for children with intractable nausea and gastroparesis

J Pediatr Surg. 2008 Mar;43(3):437-42. doi: 10.1016/j.jpedsurg.2007.10.005.

Abstract

Purpose: Gastric electrical stimulation (GES) has been performed in adults as a treatment of refractory nausea and vomiting in patients who have failed medical treatment, but has not been used in children.

Methods: Nine patients with chronic nausea and vomiting with a mean age of 14 years were evaluated for temporary GES. All 9 patients subsequently underwent placement of a temporary followed by permanent GES device. Symptoms were recorded at baseline, after temporary GES, and then after permanent GES using a Likert scale for gastroparesis. Statistical analysis was performed using a paired Student's t test.

Results: At baseline, all patients were symptomatic and most had delayed solid gastric emptying. As a group, there was a significant improvement in combined symptoms score (P = .04), nausea (P = .039), and vomiting (P = .0016). Gastric emptying and electrogastrogram values did not change significantly. Follow-up ranged from 8 to 42 months, with 7 of the 9 patients reporting sustained improvement in symptoms and improved quality of life.

Conclusions: Gastric electrical stimulation can be successfully applied to adolescents with intractable nausea and gastroparesis symptoms who fail medical therapy. There is a significant improvement in symptoms over a prolonged period, and there are no adverse effects of the GES. Long-term efficacy of this therapy in children needs to be established.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Chronic Disease
  • Cohort Studies
  • Electric Stimulation Therapy / methods*
  • Electrodes, Implanted
  • Female
  • Follow-Up Studies
  • Gastric Emptying / physiology
  • Gastroparesis / diagnosis
  • Gastroparesis / therapy*
  • Humans
  • Male
  • Nausea / diagnosis
  • Nausea / therapy*
  • Patient Satisfaction
  • Quality of Life
  • Recurrence
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Vomiting / diagnosis
  • Vomiting / therapy*