Display options
Share it on

Ann R Coll Surg Engl. 2011 Nov;93(8):624-8. doi: 10.1308/003588411X13165261994157.

Temporary gastric neuromodulation for intractable nausea and vomiting.

Annals of the Royal College of Surgeons of England

S Ullah, R Arsalani-Zadeh, P Sedman, G Avery, G S Duthie, J MacFie

Affiliations

  1. Academic Surgical Unit, Castle Hill Hospital, Castle Road, Cottingham, East Yorkshire HU16 5JQ, UK. [email protected]

PMID: 22041240 PMCID: PMC3566689 DOI: 10.1308/003588411X13165261994157

Abstract

INTRODUCTION: Gastric neuromodulation (GNM) has been advocated for the treatment of drug refractory gastroparesis or persistent nausea and vomiting in the absence of a mechanical bowel obstruction. There is, however, little in the way of objective data to support its use, particularly with regards to its effects on gastric emptying.

METHODS: Six patients (male-to-female ratio: 4:2, mean age: 49 years, range: 44-57 years) underwent the GNM between April and August 2010. Three patients had confirmed slow gastrointestinal transit. Aetiology included previous gastric surgery in two, diabetes in one and idiopathic nausea and vomiting in three patients. GNM pacing wires were placed endoscopically and left in situ for seven days. Patients underwent gastric scintigraphy before and 24 hours after the commencement of GNM. Total gastroparesis symptom scores (TSS), weekly vomiting frequency scores (VFS), health-related quality of life (using the SF-12(®) questionnaire), gastric emptying, nutritional status and weight were compared before and after GNM.

RESULTS: TSS improved after GNM in comparison with baseline data. VFS improved in three of four symptomatic patients. The SF-12(®) physical composite score improved in four patients (27.5 vs 34.3) and the mental composite score improved in five patients (34.9 vs 35.9). All patients reported an improvement in oral intake. A significant weight gain (mean: 1kg, range: 0.3-2.4kg) was observed over seven days. Gastric emptying half-time improved in four patients.

CONCLUSIONS: GNM improved upper gastrointestinal symptoms, quality of life and nutritional status in patients with intractable nausea and vomiting. GNM merits further investigation.

References

  1. Pancreas. 2004 Aug;29(2):e41-4 - PubMed
  2. Digestion. 2002;66(4):204-12 - PubMed
  3. Curr Gastroenterol Rep. 2007 Aug;9(4):286-94 - PubMed
  4. Dig Dis Sci. 1998 Nov;43(11):2398-404 - PubMed
  5. South Med J. 2005 Jul;98(7):693-7 - PubMed
  6. Am J Gastroenterol. 2003 Nov;98(11):2578 - PubMed
  7. Digestion. 2007;75(2-3):83-9 - PubMed
  8. Arch Intern Med. 1987 Aug;147(8):1477-80 - PubMed
  9. Gastroenterology. 2004 Nov;127(5):1592-622 - PubMed
  10. Diabetes Care. 2004 May;27(5):1071-6 - PubMed
  11. Am J Surg. 2003 Dec;186(6):690-5 - PubMed
  12. Am J Surg. 2001 Dec;182(6):676-81 - PubMed
  13. Neurogastroenterol Motil. 2006 Apr;18(4):263-83 - PubMed
  14. Exp Clin Endocrinol Diabetes. 2005 Jan;113(1):38-42 - PubMed
  15. Gastroenterology. 2003 Aug;125(2):421-8 - PubMed
  16. JSLS. 2005 Jul-Sep;9(3):364-7 - PubMed
  17. World J Surg. 2009 Aug;33(8):1693-701 - PubMed
  18. Gastrointest Endosc. 2005 Mar;61(3):455-61 - PubMed
  19. Arch Surg. 2005 Sep;140(9):841-6; discussion 847-8 - PubMed
  20. Gut. 2007 Jun;56(6):877-83 - PubMed
  21. Eur J Gastroenterol Hepatol. 2007 Jan;19(1):29-35 - PubMed
  22. Clin Gastroenterol Hepatol. 2005 Jan;3(1):49-54 - PubMed
  23. Chest. 2002 Dec;122(6):2038-41 - PubMed

MeSH terms

Publication Types