Cargando…

A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis

Gastroparesis or gastric stasis is the delayed transit of the ingested contents through the stomach in the absence of mechanical obstruction. It can have multiple etiologies, most commonly idiopathic (ID) and diabetic (DM). Gastroparesis can cause significant distress to patients as it leads to symp...

Descripción completa

Detalles Bibliográficos
Autores principales: Rajamanuri, Medha, Mannava, Sai Mahitha, Chhabra, Jayksh, Karwarker, Guruprasad Vasant, Chahal, Meher, Maligireddy, Anand Reddy, Dai, Eiman, Alfonso, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8457417/
https://www.ncbi.nlm.nih.gov/pubmed/34584813
http://dx.doi.org/10.7759/cureus.18152
_version_ 1784571091384008704
author Rajamanuri, Medha
Mannava, Sai Mahitha
Chhabra, Jayksh
Karwarker, Guruprasad Vasant
Chahal, Meher
Maligireddy, Anand Reddy
Dai, Eiman
Alfonso, Michael
author_facet Rajamanuri, Medha
Mannava, Sai Mahitha
Chhabra, Jayksh
Karwarker, Guruprasad Vasant
Chahal, Meher
Maligireddy, Anand Reddy
Dai, Eiman
Alfonso, Michael
author_sort Rajamanuri, Medha
collection PubMed
description Gastroparesis or gastric stasis is the delayed transit of the ingested contents through the stomach in the absence of mechanical obstruction. It can have multiple etiologies, most commonly idiopathic (ID) and diabetic (DM). Gastroparesis can cause significant distress to patients as it leads to symptoms like intractable nausea and vomiting, weight loss, abdominal bloating, early satiety, etc. The pathogenesis is mainly thought to be due to the dysfunction of the gastric pacemaker cells, i.e., interstitial cells of Cajal (ICC), and their interaction with the other gastric motor function regulatory components. There are several proposed treatment options for gastroparesis. Despite that, most patients remain refractory to medical treatment and require additional interventions for symptomatic relief. One such intervention is gastric electrical stimulation or gastric pacemaker, which aids in improving gastric motility. We have searched PubMed, PubMed Central (PMC), Medline, Science Direct, and Google Scholar for articles pertaining to the use of gastric electrical stimulation in gastroparesis published in the last 10 years. The keywords used include "gastroparesis", "gastric stasis", "gastric pacemaker'', "gastric electrical stimulation", "nausea", "vomiting", "abdominal bloating", "gastric neuromodulation". We have finally included twelve studies that were the most relevant to our research question and met the quality assessment criteria. Exclusion criteria consisted of pediatric population studies, studies conducted on animals, books, and grey literature. Overall, these twelve studies helped evaluate the impact of gastric pacemakers on symptoms of gastroparesis like nausea, vomiting, weight loss, abdominal bloating, and quality of life. We found that most studies favored gastric pacemakers, improving the incidence of nausea and vomiting in patients with gastroparesis. There was a marked improvement in the BMI as well. On the other hand, most open-labeled studies showed improved quality of life and Gastroparesis Cardinal Symptom Index (GCSI) scores, while randomized controlled trials and meta-analyses did not reflect the same result. In addition, some other parameters improved with gastric pacemakers, Inflammatory markers, insulin levels (especially in diabetics), and the number of hospitalizations. In conclusion, gastric pacemaker is a potential treatment option for patients with medically refractory gastroparesis. As noted from the results of our study, nausea/vomiting, weight loss, and overall GCSI scores have shown marked improvement with gastric electrical stimulation (GES). Nevertheless, more extensive research is needed to understand better the full extent of this device’s use as a viable treatment option for patients suffering from gastroparesis.
format Online
Article
Text
id pubmed-8457417
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-84574172021-09-27 A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis Rajamanuri, Medha Mannava, Sai Mahitha Chhabra, Jayksh Karwarker, Guruprasad Vasant Chahal, Meher Maligireddy, Anand Reddy Dai, Eiman Alfonso, Michael Cureus Internal Medicine Gastroparesis or gastric stasis is the delayed transit of the ingested contents through the stomach in the absence of mechanical obstruction. It can have multiple etiologies, most commonly idiopathic (ID) and diabetic (DM). Gastroparesis can cause significant distress to patients as it leads to symptoms like intractable nausea and vomiting, weight loss, abdominal bloating, early satiety, etc. The pathogenesis is mainly thought to be due to the dysfunction of the gastric pacemaker cells, i.e., interstitial cells of Cajal (ICC), and their interaction with the other gastric motor function regulatory components. There are several proposed treatment options for gastroparesis. Despite that, most patients remain refractory to medical treatment and require additional interventions for symptomatic relief. One such intervention is gastric electrical stimulation or gastric pacemaker, which aids in improving gastric motility. We have searched PubMed, PubMed Central (PMC), Medline, Science Direct, and Google Scholar for articles pertaining to the use of gastric electrical stimulation in gastroparesis published in the last 10 years. The keywords used include "gastroparesis", "gastric stasis", "gastric pacemaker'', "gastric electrical stimulation", "nausea", "vomiting", "abdominal bloating", "gastric neuromodulation". We have finally included twelve studies that were the most relevant to our research question and met the quality assessment criteria. Exclusion criteria consisted of pediatric population studies, studies conducted on animals, books, and grey literature. Overall, these twelve studies helped evaluate the impact of gastric pacemakers on symptoms of gastroparesis like nausea, vomiting, weight loss, abdominal bloating, and quality of life. We found that most studies favored gastric pacemakers, improving the incidence of nausea and vomiting in patients with gastroparesis. There was a marked improvement in the BMI as well. On the other hand, most open-labeled studies showed improved quality of life and Gastroparesis Cardinal Symptom Index (GCSI) scores, while randomized controlled trials and meta-analyses did not reflect the same result. In addition, some other parameters improved with gastric pacemakers, Inflammatory markers, insulin levels (especially in diabetics), and the number of hospitalizations. In conclusion, gastric pacemaker is a potential treatment option for patients with medically refractory gastroparesis. As noted from the results of our study, nausea/vomiting, weight loss, and overall GCSI scores have shown marked improvement with gastric electrical stimulation (GES). Nevertheless, more extensive research is needed to understand better the full extent of this device’s use as a viable treatment option for patients suffering from gastroparesis. Cureus 2021-09-21 /pmc/articles/PMC8457417/ /pubmed/34584813 http://dx.doi.org/10.7759/cureus.18152 Text en Copyright © 2021, Rajamanuri et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Rajamanuri, Medha
Mannava, Sai Mahitha
Chhabra, Jayksh
Karwarker, Guruprasad Vasant
Chahal, Meher
Maligireddy, Anand Reddy
Dai, Eiman
Alfonso, Michael
A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis
title A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis
title_full A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis
title_fullStr A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis
title_full_unstemmed A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis
title_short A Systematic Review of the Therapeutic Role of Gastric Pacemakers in Adults With Gastroparesis
title_sort systematic review of the therapeutic role of gastric pacemakers in adults with gastroparesis
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8457417/
https://www.ncbi.nlm.nih.gov/pubmed/34584813
http://dx.doi.org/10.7759/cureus.18152
work_keys_str_mv AT rajamanurimedha asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT mannavasaimahitha asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT chhabrajayksh asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT karwarkerguruprasadvasant asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT chahalmeher asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT maligireddyanandreddy asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT daieiman asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT alfonsomichael asystematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT rajamanurimedha systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT mannavasaimahitha systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT chhabrajayksh systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT karwarkerguruprasadvasant systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT chahalmeher systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT maligireddyanandreddy systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT daieiman systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis
AT alfonsomichael systematicreviewofthetherapeuticroleofgastricpacemakersinadultswithgastroparesis