A gastric pacemaker, or gastric electrical stimulator (GES), is a medical implant that delivers mild electrical impulses to regulate stomach function. It offers an alternative for individuals with severe, chronic digestive symptoms unresponsive to other treatments.
What is a Gastric Pacemaker and How It Works
A gastric pacemaker is a small, battery-operated device. It consists of an impulse generator, typically implanted under the skin in the abdomen, and leads (wires) connected to the outer muscle layer of the stomach. The device sends low-energy electrical pulses to the stomach wall.
These electrical pulses modulate abnormal electrical activity that causes symptoms, rather than directly stimulating stomach contractions or normalizing stomach emptying. While the exact mechanism is not completely understood, it is believed to affect nerves involved in digestion, such as the vagus nerve, and influence how the stomach perceives symptoms. The goal of this electrical stimulation is to reduce chronic symptoms like nausea and vomiting, even if stomach emptying does not significantly improve.
Conditions Treated
Gastric pacemakers primarily treat severe gastroparesis, a condition where the stomach empties its contents more slowly than normal without any physical blockage. This delayed emptying occurs because the nerves and muscles controlling stomach contractions are impaired. Common causes include uncontrolled diabetes (diabetic gastroparesis) and cases where the cause cannot be identified (idiopathic gastroparesis).
Symptoms of gastroparesis include chronic nausea, vomiting, abdominal pain, bloating, and feeling full very quickly after starting a meal. The gastric pacemaker is approved for chronic, intractable nausea and vomiting associated with diabetic or idiopathic gastroparesis when other treatments, such as dietary changes and medications, have not provided sufficient relief. While it aims to reduce these debilitating symptoms, it is not considered a cure for the underlying condition.
The Implantation Process
Implantation of a gastric pacemaker is a surgical procedure typically performed under general anesthesia. Surgeons make small incisions, often using minimally invasive laparoscopic techniques. This approach can offer benefits like a lower risk of certain complications and smaller scars.
During the procedure, the small battery-operated device is positioned under the skin, usually in the lower abdominal region. Two leads are then attached to the muscle wall of the stomach. The surgery typically takes one to two hours, and patients usually have a short hospital stay, often ranging from one to three days.
Living with a Gastric Pacemaker
After implantation, recovery usually involves a brief hospital stay. Patients are advised to avoid strenuous activities for several weeks to promote healing. Regular follow-up appointments with a healthcare provider are important to monitor healing and allow for adjustments to the pacemaker’s settings.
The device is designed to be largely unnoticed by the patient in their daily life, as it automatically delivers electrical pulses. However, patients must be aware of compatibility issues, particularly with Magnetic Resonance Imaging (MRI) scans. While some newer models may be MRI conditional, older devices are often not, and patients should always consult their doctor regarding MRI safety. The gastric pacemaker helps manage symptoms and improve quality of life, but it does not eliminate the need for continued dietary adjustments or other medical therapies for gastroparesis.