APSA PaperEfficacy of permanent gastric electrical stimulation for the treatment of gastroparesis and functional dyspepsia in children and adolescents
Section snippets
Methods and patients
Approval of a protocol for use of Enterra therapy in patients younger than 18 years of age was obtained from the Nationwide Children's Hospital IRB. Approval to conduct a retrospective review of our first 16 patients implanted with the Enterra System was later obtained from the IRB. Ten females and six males with chronic nausea, vomiting, early satiety, bloating, postprandial fullness, and epigastric pain were evaluated with gastric emptying studies by Nuclear Medicine and antro-duodenal
Results
There were ten females and six males in the study with duration of follow-up of 0.5 to 23 months. Eight of the 16 patients initially had delayed gastric emptying. All of the symptoms had a statistically significant decrease in severity and frequency after permanent GES (Fig. 1, Fig. 2 and Table 2, Table 3).
The main route of nutrition at referral was total parenteral nutrition (TPN) exclusively in three patients, jejunal feeds in three, and oral feeds in 10. The feeding patterns for the group
Discussion
Gastroparesis and functional dyspepsia are poorly understood conditions that can lead to debilitating functional and nutritional consequences in children and adolescents [2], [3]. Diabetes is the etiology of gastroparesis in 95% of adult patients whereas in the pediatric population an idiopathic etiology that is presumed to be mainly of viral origin is diagnosed in the majority of patients. Surgery has been largely ineffective in providing symptomatic relief for patients with gastroparesis and
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2022, Clinical Gastroenterology and HepatologyCitation Excerpt :First, chronic nausea may be responsive to other hypnotic suggestions than chronic abdominal pain. Chronic abdominal pain is caused by visceral hypersensitivity, while chronic nausea is likely the result of a change in gut motility.37–39 It is known, however, that hypnosis can affect both hypersensitivity and motility.
Upper Gastrointestinal Functional and Motility Disorders in Children
2021, Pediatric Clinics of North AmericaCitation Excerpt :Finally, percutaneous or implanted gastric electrical stimulation has been found safe and effective in children and adults.97 In adolescents, gastric electrical stimulation significantly improved symptom scores beyond 1 year and improved nausea and vomiting in children with FD.98,99 The authors have nothing to disclose.
Pediatric gastroparesis
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2018, Gastroenterology Clinics of North AmericaCitation Excerpt :However, it has to be noted that the symptomatic improvement of patients is not strictly related to the improvement of gastric emptying rates and might be greater than the real effect on gastric motility, similar to what has been observed with several prokinetic agents. Other studies are needed to confirm its long-term efficacy and safety in pediatric populations.52 Increasing attention has recently been drawn to the use of electrical stimulation in segments of the intestine beyond the stomach.
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