A gastric pacemaker, also known as a gastric electrical stimulator, is a small, battery-powered device designed to manage severe digestive issues. This medical intervention is surgically implanted beneath the skin, typically in the abdominal wall, and uses electrical pulses to regulate stomach function. It offers a therapeutic option for individuals whose chronic gastrointestinal symptoms have not responded to standard treatments.
How the Device Works
The device functions as a neuromodulator, delivering mild electrical signals directly to the stomach wall, specifically the serosa layer. Two insulated wires, called leads, are implanted into the stomach muscle and connected to the device’s pulse generator. The generator then emits high-frequency, low-energy electrical pulses throughout the day.
These gentle pulses are not intended to regulate the physical rhythm of the stomach in the way a cardiac pacemaker works. Instead, the electrical stimulation is thought to interfere with the neural pathways that transmit signals of nausea and vomiting from the stomach to the brain. This action helps to reduce the frequency and intensity of these symptoms. Its primary success is measured by the significant reduction in chronic nausea and vomiting, suggesting the effect on the nervous system is the main factor for symptom relief.
Why Is a Gastric Pacemaker Used
The primary indication for receiving a gastric electrical stimulator is chronic gastroparesis, a condition also known as delayed stomach emptying. This disorder involves weakened muscle contractions in the stomach, which prevents food and liquids from moving into the small intestine at a normal rate. Patients often experience persistent nausea, vomiting, bloating, and early satiety (the feeling of being full after only a few bites of food).
The condition is most commonly linked to long-standing diabetes, though it can also be idiopathic (meaning the cause is unknown). The gastric pacemaker is reserved for those who have not found sufficient relief through dietary modifications, prokinetic medications, or anti-nausea drugs. For these individuals, the device offers a way to manage distressing symptoms, potentially improving overall nutrition and quality of life.
Implantation and Post-Surgical Care
The surgical placement of the gastric pacemaker is performed using minimally invasive laparoscopic techniques, which involve small incisions and specialized instruments. The main pulse generator, about the size of a large pocket watch, is placed subcutaneously, usually in the upper abdominal wall. Two leads are then attached to the external layer of the stomach muscle.
The procedure is usually performed under general anesthesia and takes between one and three hours. Most patients require a short hospital stay, typically one to two days for observation and recovery. Post-surgical care involves managing pain and adhering to immediate dietary restrictions, such as a liquid or soft food diet. Patients must avoid strenuous activity or heavy lifting for several weeks to allow the leads to anchor and the incision sites to heal.
Living with the Device
Once recovery is complete, the gastric pacemaker is controlled externally by a clinician using a specialized programming device. These controls allow the care team to adjust the electrical stimulation settings to optimize symptom relief. This fine-tuning process may require multiple office visits and can take several weeks or months to achieve the best results.
Patients must be mindful of the device’s interaction with external fields, as strong magnets or certain medical procedures can interfere with its function. For example, some devices are conditionally safe for magnetic resonance imaging (MRI), but consultation is required before any scan. Patients should also inform airport security screeners and other healthcare providers that they have an implanted stimulator. The pulse generator battery typically lasts five to ten years, requiring a simple procedure to replace the generator afterward.