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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2021
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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 |
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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 |
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