J Neurogastroenterol Motil.
2016 Oct;22(4):643-649. 10.5056/jnm15135.
Gastric Electrical Stimulation Is an Option for Patients with Refractory Cyclic Vomiting Syndrome
- Affiliations
-
- 1Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
- 2Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville, KY, USA. thomas.abell@louisville.edu
- 3Division of Digestive Diseases, University of Mississippi Medical Center, Jackson, MS, USA.
- 4Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
- 5Department of Pediatric Gastroenterology, University of Missouri Health Care, Columbia, MO, USA.
- KMID: 2433456
- DOI: http://doi.org/10.5056/jnm15135
Abstract
- BACKGROUND/AIMS
Cyclic vomiting syndrome (CVS) is a disabling migraine variant manifesting as severe episodes of nausea and vomiting and often refractory to many therapies. Gastric electrical stimulation (GES), which can reduce nausea and vomiting in gastroparesis, may provide symptomatic relief for drug-refractory CVS. This study assessed the utility GES in reducing the symptoms of CVS and improving the quality of life.
METHODS
A one-year, non-randomized, clinical study was conducted. Eleven consecutive patients with drug refractory, cyclic vomiting syndrome based on Rome III criteria and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN), underwent treatment with temporary GES (Temp GES) and permanent GES (Perm GES). Post-treatment follow up was done up to one year after permanent gastric electrical stimulation therapy.
RESULTS
Total symptom score decreased by 68% and 40% after temporary and permanent GES therapies, respectively. Hospital admission events significantly decreased to 1.50 (± 1.00) events from 9.14 (± 7.21) annual admissions prior to treatment with permanent GES. Vomiting episodes fell by 83% post Temp GES and 69% after Perm GES treatments. Mucosal electrogram values also changed after temporary stimulation.
CONCLUSIONS
In a small group of drug-refractory CVS patients, treatments with temporary and permanent GES significantly reduced the severity of gastrointestinal symptoms and frequency of hospital admissions.
