Gastric electrical stimulation increases the discomfort threshold to gastric distension

Abstract

Introduction: Gastric electrical stimulation (GES) is now considered as a new therapeutic alternative for patients with medically refractory vomiting and/or nausea, although its mechanisms of action remain poorly understood.

Methods and patients: Gastric discomfort threshold, measured as the gastric maximal tolerable volume (MTV) to distension, was examined before and after GES, in nine patients implanted for chronic and severe nausea and vomiting.

Results: GES increased gastric MTV from 522 ± 64 ml at baseline to 628 ± 60 ml 6 months after the start of GES (P=0.03), whereas gastric emptying remained unchanged. The increase in MTV was correlated with symptoms and quality of life at 6 months, whereas gastric emptying was not. Finally, MTV varied in a similar manner at 6 months in patients with delayed and normal gastric emptying measured before implantation.

Conclusion: Taken together, these data indicate that modification of gastric sensation to distension, rather than gastric emptying, is associated with symptoms' outcome during GES.