Gastroparesis and the gastric pacemaker: a revolutionary treatment for an old disease

Gastroparesis--or delayed gastric emptying--can apply to either solids or liquids but the term (gastroparesis) usually refers to delayed solid emptying, in an appropriate clinical setting. Impaired gastric emptying can occur acutely in a variety of conditions from neurologic to metabolic. Intractable nausea and vomiting, and the inability to tolerate oral intake, occurs frequently in patients with severe gastroparesis. The patients' nutritional status is adversely affected by gastroparesis as are the socioeconomic aspects of patient's lives. The previous treatments of gastroparesis, such as medications and surgery, were often not successful. Our recent understanding of the normal gastric electro-mechanical function and its abnormalities/dysrythmias has led to the development of a gastric electrical stimulator, analagous to other devices used to stimulate dysfunctional organs. Gastric electrical stimulation is associated with improvements in symptomatic relief, nutritional status, health resource utilization and costs and is now approved by the FDA as a humanitarian use device. It offers a new and hopeful therapy for patients with refractory gastroparesis where none have existed before.