Gastric electrical stimulation cuts vomiting frequency

Gastric electrical stimulation (GES) is effective against refractory vomiting, a new study has found.

Researchers conducted a randomized, double-blind trial including 172 patients (mean age, 45±12 years; 66 percent) who had had refractory vomiting for more than 12 months. Participants were randomly assigned to receive 4 months of 330-µsec GES pulses at 14 Hz, 5 mA or no stimulation. This was followed by another 4 months in which the remaining 149 patients crossed over to the other group.

At baseline and before GES device implantation, 60 percent of the participants reported vomiting several times a day; 17 percent reported episodes at least once a day, while 16 percent vomited several times a week.

A simple 5-point vomiting scale was employed and showed that when the GES device was turned on, participants obtained a mean score of 2.2±1.7, as opposed to an average of 1.8±1.7 when the device was off (p=0.0009). Higher scores on the scale meant lower vomiting frequencies.

Moreover, significantly more participants reported at least a 1-point improvement in the vomiting score when the GES device was on vs off (30.6 percent vs 16.5 percent; p<0.05). This remained true even when disaggregating the sample into diabetics and nondiabetics.

However, these beneficial effects of GES failed to translate to significant quality of life improvements, as measured by the gastrointestinal quality of life index (GIQLI). There was no significant difference in index scores between the on and off conditions (73.3±23.0 vs 71.1±22.6; p=0.06), which was similarly reflected in both diabetics (p=0.23) and nondiabetics (p=0.15).