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Impact of Gastric Electrical Stimulation on Gastrointestinal and Non-Gastrointestinal Somatic Symptoms
Eduardo Castillo-Leon1, Kathryn E Hawa2, Amina Usman1
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
Insights
Gastric electrical stimulation (GES) offers sustained relief for refractory nausea and vomiting in children, improving quality of life. However, its effect on non-gastrointestinal somatic symptoms is only temporary.
Area of Science:
- Pediatric Gastroenterology
- Medical Device Technology
- Symptom Management
Background:
- Refractory nausea and vomiting in children often necessitate advanced treatments like Gastric Electrical Stimulation (GES).
- The efficacy of GES on non-gastrointestinal (non-GI) symptoms in pediatric patients is not well-established.
- Understanding the full impact of GES is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate the long-term effects of GES on both gastrointestinal (GI) and non-GI somatic symptoms in pediatric patients.
- To assess the impact of GES on quality of life in children with refractory GI issues.
- To determine if GES influences symptoms beyond the digestive system.
Main Methods:
- A cohort of 34 pediatric patients (<21 years) treated with GES between 2016-2024 was analyzed.
- Patients completed validated questionnaires (SMW, PedsQL, CSSI) at baseline and multiple follow-up points up to 12 months.
- Linear mixed effects regression models were used to analyze score changes and symptom response.
Main Results:
- Sustained improvements were observed in GI symptoms (SMW) and quality of life (PedsQL) after one year of GES.
- Non-GI somatic symptoms (CSSI) showed initial improvement within 6 months, but this was not statistically significant at 12 months.
- Both high and low response groups to GES experienced transient improvements in non-GI somatic symptoms.
Conclusions:
- Gastric Electrical Stimulation (GES) provides sustained benefits for refractory GI symptoms and enhances quality of life in pediatric patients.
- The positive effects of GES on non-gastrointestinal somatic symptoms appear to be transient.
- Further research may be needed to optimize GES for broader symptom management in children.
Background:
Gastric electrical stimulation (GES) improves refractory nausea and vomiting in children, but the impact on non-gastrointestinal symptoms remains unclear.
Methods:
We identified patients < 21 years old treated with GES between 2016 and 2024. Patients completed the Symptom Monitor Worksheet (SMW), Pediatric Quality of Life Inventory (PedsQL), and Children's Somatic Symptoms Inventory (CSSI) at baseline before GES and at 14 days, 2, 6, and 12 months follow-up. We used a linear mixed effects regression model and a random intercept for each subject to capture individual variability in assessment of score changes during the first year and to evaluate differences in CSSI based on symptom response defined as > 1 point improvement in average SMW score from baseline to last follow-up.
Results:
We included 34 patients (79% female, mean age 15.4 years): 97% had gastroparesis, 50% functional dyspepsia, 47% postural orthostatic tachycardia syndrome, and 67% a history of anxiety/depression. After 1 year of GES treatment, there was sustained improvement in SMW and PedsQL. CSSI improved over the first 6 months and remained improved numerically at the end of the year, but this was not statistically significant. Sixteen patients met criteria for greater response and 18 for lesser response based on degree of SMW improvement. Baseline CSSI, including GI and non-GI subsets, was similar between patients with greater and lesser response to GES, and both experienced transient improvement in the non-GI somatic symptoms.
Conclusion:
Children treated with GES experienced sustained improvement in GI symptoms and quality of life, but only transient improvement in non-GI somatic symptoms.
