Enterra Gastric Pacemaker

For Gastroparesis

What Is Gastroparesis?

Gastroparesis is a medical condition that affects how the stomach muscles function. Normally, food is propelled through the digestive tract with strong muscular contractions; for people with gastroparesis, the muscles in the wall of the stomach malfunction or don’t function at all, and the stomach cannot empty itself properly. This affects digestion, causes nausea and vomiting and can alter blood sugar levels. Gastroparesis can also cause psychological and mental side effects, too; people that struggle with the condition may be constantly uncomfortable, suffer poor work/school performance and avoid social activities or personal relationships.
Gastroparesis may be caused by damage to the vagus nerve or by severe type 2 diabetes. Most people with gastroparesis have one or more of the following symptoms:
  • Nausea

  • Vomiting after meals

  • Pain in the abdomen

  • Bloating

  • Feeling full after eating small quantities of food

  • Lack of appetite

  • Excessive unintentional weight loss

Gastroparesis is diagnosed through a special test called a gastric emptying study, in which special chemicals measure how fast food leaves the stomach.

Treatments For Gastroparesis

There is no cure for gastroparesis, but certain treatments can soothe symptoms and improve quality of life. Usually, patients are encouraged to make diet modifications to reduce symptoms and ensure sufficient nutrition and hydration levels. These modifications may include getting more liquids, restricted fats and plant fiber, and eating smaller, more frequent meals. Drug therapy is another option; prokinetic drugs can be used to improve the rate at which the stomach empties, and antiemetic drugs can control nausea and vomiting (without affecting how the stomach empties).
If these diet modifications do not help, and the patient has severe gastroparesis, enteral nutrition (a feeding tube) may be recommended as a temporary solution. Enteral nutrition involves delivering liquid nutrients to the patient’s bloodstream through a small tube placed in the stomach or small intestine.
Surgery is often the last resort for gastroparesis treatment. A laparoscopic procedure called pyloroplasty is designed to widen the muscle that separates the stomach from the upper portion of the small intestine. Food then passes from the stomach to the small intestine quicker and with less effort. After a pyloroplasty, diet and nutrition are closely monitored.

Enterra Therapy For Chronic Gastroparesis

Bariatric Surgeon Dr. Buchin is one of the only surgeons in the North Shore LIJ Health System and in Long Island to offer the newest treatment option for gastroparesis: Enterra Therapy, which is essentially a gastric pacemaker. Enterra Therapy is intended for individuals with chronic gastroparesis stemming from gastroparesis of diabetic or idiopathic origin that have chronic, drug-resistant nausea and vomiting. The Enterra neurostimulator is surgically placed in the stomach. Two leads, connected to the stomach muscles, electrically stimulate the nerves and muscles of the stomach to promote normal gastric movement. With this movement, food should empty normally into the small intestine for digestion. The WAVESS (Worldwide Anti-Vomiting Electrical Stimulation Study) showed that the Enterra device gave most patients relief of vomiting.

Risks Of Surgery

There are several risks associated with implanting the neurostimulator, including the following:
  • Infection where the electrical stimulation system parts are implanted

  • Adverse reaction to or rejection of the implanted device

  • Temporary or permanent neurologic complications

  • Pain, discomfort and/or bruising at the surgical site

Side effects from Enterra therapy include gastrointestinal symptoms, abdominal pain and complications with the feeding tube. Patients may also experience difficulty swallowing, dehydration, acute diabetic complications and poor healing/results. Anyone considering treatment with the Enterra neurostimulator should consider the following possible complications:
The system parts may wear through the skin, causing infection or scarring. The neurostimulator could stop because of mechanical or electrical problems, requiring additional surgery. It could perforate the stomach, requiring surgery. System malfunction could cause tissue damage. These risks, side effects and possible complications can be discussed with Dr. Buchin during a personal consultation. Contact him today to make an appointment.
If you would like more information about potential risks, side effects, and complications of neurostimulation please contact our Long Island office at (631) 351-2024 to schedule a consultation.