Gastric neuromodulation with Enterra system for nausea and vomiting in patients with gastroparesis

Neuromodulation : Journal of the International Neuromodulation Society
Jieyun YinJiande D Z Chen

Abstract

Gastric electrical stimulation (GES) has been introduced for treating gastric motility disorders, such as gastroparesis, and obesity. A special method of GES using high frequency-short pulses, called Enterra® Therapy, has been clinically applied to treat nausea and vomiting in patients with gastroparesis. However, its mechanisms are not well understood. General methodologies of GES published in the literature are systematically reviewed and their main effects and application are presented. The major part of this review is focused on Enterra Therapy since this is the only method that has been used clinically. A number of different GES methods have been proposed. GES with long pulses or dual pulses, but not short pulses, are able to alter (enhance or inhibit) such parameters of gastric motility as gastric slow waves and gastric emptying. Synchronized GES has been reported to improve antral contractions. GES with high frequency-short pulses, or Enterra Therapy, is known to improve nausea and vomiting in patients with gastroparesis and has a response rate of 50-70%. Improved gastric accommodation, direct enteric nervous system effects, enhanced vagal activity, and activation of central neurons are believed to be the underlying mech...Continue Reading

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