Gastric Pacemaker Significantly Improves Severe Gastroparesis
Electrical stimulation therapy offers hope for relief of chronic nausea and vomiting
Physicians at the Medical University of South Carolina now offer a therapy that provides hope to patients suffering from certain types of gastroparesis, a debilitating stomach disorder common in people with diabetes, among other conditions.
Medtronic Enterra® Therapy uses mild electrical pulses, called gastric electrical stimulation (GES), to stimulate the stomach. This electrical stimulation may help control the symptoms associated with gastroparesis of diabetic or idiopathic origin, including nausea and vomiting, when medications have not been effective.
Gastroparesis is a chronic disorder in which food passes through the stomach more slowly than normal. For some people, this condition results in serious nausea and vomiting that cannot be adequately controlled with standard medical therapy and can lead to potentially life-threatening complications such as dehydration and malnutrition. These patients have difficulty eating and drinking and may require some form of intravenous or tube feeding to ensure adequate nutrition.
MUSC's First Gastric
Susie is a 26-year-old white female who was diagnosed with idiopathic gastroparesis many years ago. She initially responded partially to medical management but over time her gastroparesis continued to worsen. Eventually, she was vomiting 10-12 times daily despite maximal medical management and she was on tube feeds seven days per week. She was unable to eat anything without pain, bloating, and vomiting. Despite tube feeds, Susie continued to lose weight, weighing 103 lbs. at her lowest. She was being referred to the University of Mississippi for a gastric pacemaker, but she wanted to have her surgery done at MUSC.
Dr. Adams and Stefanie Owczarski, PA-C, worked with the Institutional Review Board to gain approval for implant of this Humanitarian Use Device. With IRB approval, Dr. Adams implanted her Gastric Pacemaker in July 2010. Since that time, Susie's settings have been able to be adjusted so that she no longer requires tube feeds, she now eats every day, and her J-tube is removed. Her weight is up to 149 lbs and she only vomits 2-3 times daily.
Prior to surgery, her daily pain scale averaged 6 out of 10; ever since her surgery, her pain scale has been 0 out of 10. Finally, her Physical Quality of Life has more than doubled since her surgery and her Mental Health Quality of Life has remained strong and stable. She is very happy with the results of her surgery and she is even more grateful for Dr. Adams' willingness to perform this surgery. Her desire to have this surgery performed at MUSC has also opened the door for many other patients with severe gastroparesis.
Dr. Adams has implanted many more pacers since Susie's procedure and he has consistantly remained in the top five nationally for number of Medtronic pacer surgeries performed.
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“Gastroparesis results in persistent nausea and vomiting that sometimes cannot be managed with medical therapy. Many patients with gastroparesis also have malnutrition because they cannot eat without severe nausea and vomiting. Patients with the most severe form of gastroparesis have to get their nutrition through a feeding tube,” said David Adams, M.D. and Chief of the Division of Gastrointestinal and Laparoscopic Surgery at the Medical University of South Carolina. “Placement of a gastric pacemaker with minimally invasive surgery can restore patients to a better quality of life. They can often resume eating and living a healthy life shortly after the surgery.”
Listen to Dr. David Adams as he walks you through a gastric pacemaker procedure.
Read more about Living with a Neurostimulator.
Gastroparesis is often associated with diabetes. More than 18 million Americans (or 6 percent of the population) have diabetes, and this number is on the rise. An estimated 25 percent to 30 percent of people with diabetes may have gastroparesis, and this percentage increases with time (up to 50 percent). Gastroparesis affects an estimated 40 percent to 50 percent of people with type 1 diabetes and 30 percent to 40 percent of people with type 2 diabetes. Diabetes is not the only condition associated with gastroparesis. In one study of gastroparesis patients, about one-third had diabetes, and about one-third had idiopathic gastroparesis, meaning the origin of the condition was unknown. Post-surgical gastroparesis was the next most common, followed by Parkinson’s disease, vascular disease and pseudo-obstruction, a condition that causes symptoms like those of a bowel obstruction (blockage).
Enterra Therapy is from Medtronic, the world leader in implantable medical technologies. It is approved by the U.S. Food and Drug Administration as a Humanitarian Use Device.
For more information about Enterra Therapy, or to determine if you are a candidate, contact Mary Johnson, RN, in the Division of Gastrointestinal and Laparoscopic surgery at the Medical University of South Carolina at (843) 876-3090.