Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
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Original Article

Volume 11, Number 5, October 2018, pages 349-354

Efficacy of Gastric Electrical Stimulation for Gastroparesis: US/European Comparison


Figure 1.
Figure 1. The European centers (a) has a larger mean proportion of DGP patients compared to US centers (b) (59% vs. 22%) and a smaller mean proportion of IGP patients (25% vs. 72%). The figures show the number of patients (IGP, DGP, PGP) at each centre (A-H).
Figure 2.
Figure 2. Algorithm for diagnosis and treatment of gastroparesis in US vs. Europe (European differences in bold).


Table 1. Data From US and European Centers
CenterNumber of patientsSex: FSex: MAgeIGPDGPPGPGETMonthsChange in TSS
The proportion of males to females was 1:4.2 in the US and 1:1.7 in Europe. Values for GET, months since implant, change in vomiting, and change in total symptom score (TSS) are presented as means. IGP: idiopathic gastroparesis; DGP: diabetic gastroparesis; GET: gastric emptying test; F: female; M: male.


Table 2. Fisher Exact Test to Determine Gender Differences in Gastroparesis Patients by Region
MaleFemaleTotalsP-value (< 0.05)
United States61258319
Totals84269380< 0.05


Table 3. Difference Between the Etiologies of Gastropathy Treated with GES by Region
IGPDGPPGPTotalsP-value (< 0.05)
United States2317117319
Totals24610727380< 0.05


Table 4. Metanalyses Assessing Effectiveness of Gastric Electrical Stimulation
Study titleAuthorsGeneral conclusion
NICE guidance on gastroelectrical stimulation for gastroparesisKong (2015) [17]Severe diabetics with severe symptoms may benefit from therapy.
High-frequency gastric electrical stimulation for the treatment of gastroparesis: a meta-analysisO’Grady et al (2009) [20]Beneficial in improving symptoms in patients with gastroparesis.
Systematic review and meta-analysis: gastric electrical stimulation for gastroparesisLevinthal et al (2017) [19]Argues against the use of GES outside of strict clinical trials as viable treatment option.
Gastric electrical stimulation with the Enterra system: a systematic reviewLal et al (2015) [16]GES appears to offer significant improvement in symptom control in a subset of patients.
Treatment of high-frequency gastric electrical stimulation for gastroparesisChu et al (2012) [18]GES is an effective modality for treating gastroparesis refractory to less invasive treatment.


Table 5. Controlled Trials Assessing Effectiveness of Gastric Electrical Stimulation
Study titleAuthorsGeneral conclusion
A double-masked, randomized, placebo-controlled trial of temporary endoscopic mucosal gastric electrical stimulation for gastroparesisAbell et al (2011) [23]Temporary GES may improve symptoms such as vomiting.
Gastric electrical stimulation is associated with improvement in pancreatic exocrine function in humansLuo et al (2004) [25]GES had noted effects on autonomic control, improvement in exocrine pancreatic enzyme release, and improvement in GI symptoms.
Gastric electrical stimulation for medically refractory gastroparesisAbell et al (2003) [22]GES set to high-frequency/low-energy decreased vomiting frequency and GI symptoms.
Gastric electrical stimulation with Enterra therapy improves symptoms of idiopathic gastroparesisMcCallum et al (2013) [26]GES implanted with ON stimulation was shown to decrease vomiting symptoms and days of hospitalizations.
Gastric electrical stimulation with Enterra therapy improves symptoms from diabetic gastroparesis in a prospective studyMcCallum et al (2010) [27]GES for 6 weeks significantly reduced vomiting and gastroparetic symptoms for diabetic gastroparesis.
Effectiveness of gastric electrical stimulation in gastroparesis: results from a large prospectively collected database of a national gastroparesis registryAbell et al (2015) [24]Patients treated with GES had clinically significant improvement in gastroparesis symptoms.
Gastric electrical stimulation (GES) for refractory vomiting: results of a prospective multicenter double-blinded randomized controlled cross-over trialDucrotte et al (2017) [21]GES was associated with significant reduction of symptoms in both diabetic and non diabetic gastroparesis patients.
Is gastric electrical stimulation superior to standard pharmacologic therapy in improving GI symptoms, healthcare resources, and long-term healthcare benefits?Cutts et al (2005) [28]GES was found to be more effective in improving long-term GI symptoms, decreased costs, and less use of healthcare resources than intensive medical therapy.