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St. Joseph Hospital debuts gastric electric stimulation

After being implanted, the gastric pacemaker is controlled by an external programmer doctors use to increase or decrease stimulation.For those suffering from neuromuscular stomach disorders like gastroparesis, a new procedure at St. Joseph Hospital called gastric electric stimulation can help relieve some of the painful, chronic symptoms that make this ailment so debilitating.

Gastric stimulation is an innovative approach to treating patients with chronic nausea and vomiting, both symptoms of gastroparesis. The therapy involves a gastric pacemaker (small device at left), which functions in the same way as a cardiac pacemaker with one exception – instead of stimulating the heart muscle, a gastric pacemaker uses mild electrical pulses to stimulate the nerves and smooth muscle of the lower stomach, helping relieve symptoms.

Gastroparesis is a neuromuscular stomach disorder in which food empties from the stomach more slowly than normal. In most people, undigested food moves from the stomach into the small intestine within two to four hours after eating; however, people with gastroparesis retain a significant amount of food in the stomach for a prolonged amount of time.

Patients with gastroparesis experience a variety of upper gastrointestinal symptoms that prevent them from eating normally, which can lead to dehydration, weight loss and eventually lie-threatening electrolyte imbalances and malnutrition. Other warning signs include: excessive weight gain, abdominal bloating, lack of appetite, heartburn, repeated hospitalizations with supplemental nutrition needed due to excessive nausea and vomiting, and inadequate pharmaceutical relief of symptoms.

"There is no cure for gastroparesis but there are treatment options that can control the symptoms of chronic vomiting and nausea," said Dr. Kusum Stokes, a gastroenterologist in Eureka. "Gastric stimulation is one of the newest, most effective ways of treating these symptoms."

A gastric pacemaker uses mild electrical pulses to stimulate the nerves and smooth muscle of the lower stomach, helping relieve symptoms of gastroparesis Patients identified as good candidates for a gastric pacemaker undergo a surgical procedure that lasts about one to two hours. During the procedure, a physician implants a small, battery-powered neurostimulator about the size of a pocket watch beneath the skin, usually in the lower abdominal region. Two intramuscular leads are then implanted into the muscle wall of the stomach and connected to the neurostimulator (see rendering on the right). After the device is implanted, the doctor uses a handheld, external programmer (shown in the image at the top of the page on the right) to adjust the neurostimulator and customize the stimulation for each patient. Stimulation can be adjusted without surgery. The stimulation can be turned off by the doctor at any time if a patient experiences any intolerable side effects.

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