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Long-term outcomes of gastric electrical stimulation in children with gastroparesis
Saleem Islam1, Jillian McLaughlin1, Justine Pierson2
1Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, Gainesville, FL, United States.
Insights
Gastric electrical stimulation (GES) offers a safe and effective treatment for children with severe gastroparesis, showing sustained symptom improvement for over a year in the largest pediatric study to date.
Area of Science:
- Pediatric Gastroenterology
- Medical Device Technology
- Clinical Outcomes Research
Background:
- Gastric electrical stimulation (GES) is established for adult gastroparesis.
- Pediatric application of GES remains limited.
- This study details the largest pediatric GES experience and long-term outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of GES in children with gastroparesis.
- To report long-term outcomes of pediatric GES.
- To establish GES as a viable treatment for pediatric intractable gastroparesis.
Main Methods:
- A 10-year retrospective analysis of pediatric patients undergoing GES.
- Collection of demographic, clinical history, and outcome data.
- Comparison of symptom scores using validated Likert scales and paired Student's t-test.
Main Results:
- 97 children received GES; most were adolescent Caucasian females.
- Temporary GES (tGES) in 96 patients led to symptom improvement in 66.
- Permanent GES (pGES) in 67 patients showed significant symptom reduction (p<0.001) sustained beyond 12 months.
Conclusions:
- This study represents the most extensive pediatric GES experience.
- GES is a safe and effective therapy for select pediatric patients with intractable gastroparesis.
- Symptomatic improvement persists for at least one year post-treatment.
Background:
Gastric electrical stimulation (GES) has been used in adults with gastroparesis. However its use has been limited in children. We describe the largest experience with GES in children with long-term outcomes.
Methods:
Data were collected on children who underwent GES over a 10-year period. Data regarding demographics, medical history, hospital course, and outcomes were collected and analyzed. Symptom scores (validated Likert scores) were compared using a paired Student's t test.
Results:
Overall, 97 patients underwent GES, and a majority were teenage Caucasian girls. Ninety-six had temporary GES (tGES), and 66 had improvement in their symptoms. A total of 67 underwent permanent implantation (pGES), and there was significant reduction in all individual symptoms (p<0.001) as well as the total symptom score (TSS) (p<0.0001) at 1, 6, 12, and >12 months. Recurrence of symptoms leading to device removal occurred in 7 cases. Forty-one patients had continued improvement in symptoms for over 12 months, with a mean follow-up of 3.5 years (range 1-9 years).
Conclusions:
This study represents the largest experience of systematic application of GES in children. GES is a safe and effective therapy for selected children with intractable GP with continued symptomatic improvement at 1 year and beyond.
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