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Is gastric electrical stimulation an effective therapy for patients with drug-refractory gastroparesis?

Nature Clinical Practice Gastroenterology & Hepatology volume 5, pages 368–370 (2008)Cite this article

Gastroparesis is a poorly defined chronic digestive disorder that is difficult to treat. This disorder is most rigorously defined as symptoms of, and evidence for, gastric retention in the absence of mechanical obstruction.1 Symptoms attributed to gastroparesis are variable and nonspecific and include a wide array of dyspeptic complaints of which nausea, vomiting, bloating and early satiation are most frequently described.1 The “gold standard” for the diagnosis of gastroparesis is the demonstration of delayed gastric emptying in a symptomatic individual after other symptom etiologies have been excluded; a scintigraphic gastric emptying study of a solid meal is considered the diagnostic measure of choice.

Unfortunately, the relationship between scintigraphic findings and symptoms attributed to gastroparesis is, at best, weak.2 An abnormal gastric emptying study cannot solely be used for the diagnosis of gastroparesis since abnormalities of gastric emptying can be attributed to a variety of medical conditions, central nervous system events, psychopathology, medications and poorly performed scintigraphic studies. Importantly, the finding that an individual has abnormal gastric emptying does not provide therapeutic guidance.3 Specifically, there is no compelling evidence that prokinetics are of greater value in patients with symptoms of gastroparesis who have evidence of delayed gastric emptying than in patients with the same symptoms who have normal gastric emptying studies. A combination of variable and nonspecific symptoms is, therefore, labeled as a disease on the basis of a gold standard diagnostic procedure that provides variable and nonspecific diagnostic information, and little therapeutic guidance.

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  1. Division of Gastroenterology, Suite 1400, 676 North St Clair Street, Chicago, IL 60611-2908, USA mpjones@nmh.org

Authors and Affiliations

  1. MP Jones is Associate Professor of Medicine at the Northwestern Feinberg School of Medicine, Chicago, IL, USA.,

    Michael P Jones

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Jones, M. Is gastric electrical stimulation an effective therapy for patients with drug-refractory gastroparesis?. Nat Rev Gastroenterol Hepatol 5, 368–370 (2008). https://doi.org/10.1038/ncpgasthep1157

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