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Gastric Electrical Stimulation Is Associated With Improvement in Pancreatic Exocrine Function in Humans

Objective: To define the possible effects of gastric electrical stimulation (GES) for gastroparesis on pancreatic function, we performed 2 related human studies. Methods: Fecal elastase values were compared in 2 patient groups: (1) GES devices ON and (2) GES devices OFF and (2) in 3 control groups: (1) no response (NR) to prokinetic medications, (2) positive response (RES) to medications, and (3) normal controls. Polypeptide levels in 7 of 9 GES patients with device ON and OFF, elastase results, GI symptoms (TSS), and heart rate variability (HRV) were compared by paired t tests and/or ANOVA and reported as mean ± SE. Results: Elastase was different for GES-ON and OFF (508.0 ± 92.2 vs. GES-OFF 378.6 ± 87.4, P < 0.05). Elastase was lower in medication NR and RES than in normal controls. Postprandial pancreatic polypeptide was greater with GES ON than OFF (P = 0.07). HRV revealed a lower percentage of change with device ON versus OFF (44.2 ± 5.5 vs. 48.5 ± 5.2, P = 0.08) and lower TSS with ON versus OFF (15.9 ± 4.5 vs. 25.7 ± 5.3, P < 0.05). Conclusions: GES improves exocrine pancreatic release, effects autonomic control, and improves GI symptoms, suggesting a possible role for GES in the treatment of pancreatic insufficiency associated with gastroparesis.