Gastric Pacemaker

Gastric Pacemaker In 2000, the FDA approved Gastric Electrical Stimulation, Enterra, as a way to treat those who suffered from intractable chronic nausea and vomiting. The Humanitarian Device Exemption came into place to treat this condition that is secondary to a condition that is the result of Diabetes called gastroparesis. Enterra utilizes a low energy but high frequency stimulation of the pacemaker that is naturally in the curve of the stomach. This procedure is achieved with two electrodes that are positioned using an open technique or laparoscopic technique.

What Is a Gastric Pacemaker?
A gastric pacemaker is the device used to stimulate the nerves in the lower portion of the stomach. The device is called Enterra and is an FDA approved Gastric Electrical Stimulation technique that is used to relieve chronic vomiting and nausea. The electrical stimulation pulsates to get the stomach to contract which in turn helps to alleviate the vomiting and nausea. The procedure to implant the stomach pacemaker is almost non-invasive as it is placed just under the skin in the abdomen right below the rib cage. Implanted into the stomach are two lead intramuscular wires that have electrodes on it to send out regular pulsations to help ease the stomach problems. You can turn this therapy on and off when you want to and you can even reverse it and have it removed when you feel you no longer need it.

What Can a Stomach Pacemaker Do?
The purpose of the stomach or gastric pacemaker is to use electrical stimulation through a device that is placed in the lower portion of the abdomen in order to relax the muscles in the stomach and help eliminate vomiting and nausea.

Some people who have these symptoms have what is called gastroparesis. This condition centers on the muscles and nerves in the stomach and causes the stomach to delay the release of food into the small intestine. The cause of gastroparesis is usually diabetes but there are some disorders that stem from the nervous system that could also be the culprit. The gastric electrical stimulation is used primarily for diabetic patients or those who cannot find any relief through prescription medication.

How Is a Gastroparesis Pacemaker Implanted?
If you are in need of a gastroparesis pacemaker, what is involved in putting one in? If nothing else has worked for you so far to eliminate your nausea and vomiting, consult a gastroenterologist to see if he can recommend Enterra Therapy. The physician will perform the procedure using general anesthesia in two parts – implanting the device and post-implant.

The gastroparesis pacemaker is very much like a heart pacemaker in size. The operation can take from one to three hours to complete and the electrodes are attached to the stomach wall using laparotomy or laparoscopy. Once the electric stimulator is in place under the skin in the abdominal wall, the lead wires are attached to the neurostimulator. The patient will usually remain in the hospital anywhere from one to five days depending on how well they are responding to the procedure and any of their pre-existing health conditions.

The post-implant procedures involve ongoing adjustments to the electrical device to keep it working at an optimal level. These adjustments can be performed in a non-invasive manner in an outpatient facility. The follow up for this procedure is from 6 to 12 months.

What Are the Possible Risks and Complications?
Before signing on for a gastric pacemaker, you should be fully aware of all of the possible side effects and complications.

Risks of Surgery

As with any surgical procedure there are always going to be risks. With this procedure, you are looking at the following risks, side effects, and complications:

• Infection


• Pain where the surgery was performed


• Bleeding


• An allergic reaction to the materials that were implanted


• Neurologic complications that could be temporary or permanent


• Bruising where the device has been implanted

Possible Side Effects

• Pain in the abdomen


• Problems swallowing


• Dehydration


• Gastrointestinal reactions


• Complications from the feeding tube


• Complications from the diabetes


• The device may stop working on your symptoms

Possible Device Complications

• You could suffer from an infection, pain or healing may be delayed in the area where the gastric electrical stimulation device has been implanted.


• The parts from the device could come through the skin in your abdomen resulting in an infection and/or a scar.


• If the neurostimulator is or becomes defective, a second operation would be required to remove it and replace it with another device.


• Your body could reject the device as being a foreign object or you may suffer from an allergic reaction.


• Some of your tissues could become damaged from the settings of the stimulation or if any of the parts of the device do not operate properly.


• You could suffer from a perforation to your stomach from the lead; this would require additional surgery.

Gastric Pacemaker

Gastric Pacemaker

In 2000, the FDA approved Gastric Electrical Stimulation, Enterra, as a way to treat those who suffered from intractable chronic nausea and vomiting. The Humanitarian Device Exemption came into place to treat this condition that is secondary to a condition that is the result of Diabetes called gastroparesis. Enterra utilizes a low energy but high frequency stimulation of the pacemaker that is naturally in the curve of the stomach. This procedure is achieved with two electrodes that are positioned using an open technique or laparoscopic technique.

What Is a Gastric Pacemaker?
A gastric pacemaker is the device used to stimulate the nerves in the lower portion of the stomach. The device is called Enterra and is an FDA approved Gastric Electrical Stimulation technique that is used to relieve chronic vomiting and nausea. The electrical stimulation pulsates to get the stomach to contract which in turn helps to alleviate the vomiting and nausea. The procedure to implant the stomach pacemaker is almost non-invasive as it is placed just under the skin in the abdomen right below the rib cage. Implanted into the stomach are two lead intramuscular wires that have electrodes on it to send out regular pulsations to help ease the stomach problems. You can turn this therapy on and off when you want to and you can even reverse it and have it removed when you feel you no longer need it.

What Can a Stomach Pacemaker Do?
The purpose of the stomach or gastric pacemaker is to use electrical stimulation through a device that is placed in the lower portion of the abdomen in order to relax the muscles in the stomach and help eliminate vomiting and nausea.

Some people who have these symptoms have what is called gastroparesis. This condition centers on the muscles and nerves in the stomach and causes the stomach to delay the release of food into the small intestine. The cause of gastroparesis is usually diabetes but there are some disorders that stem from the nervous system that could also be the culprit. The gastric electrical stimulation is used primarily for diabetic patients or those who cannot find any relief through prescription medication.

How Is a Gastroparesis Pacemaker Implanted?
If you are in need of a gastroparesis pacemaker, what is involved in putting one in? If nothing else has worked for you so far to eliminate your nausea and vomiting, consult a gastroenterologist to see if he can recommend Enterra Therapy. The physician will perform the procedure using general anesthesia in two parts – implanting the device and post-implant.

The gastroparesis pacemaker is very much like a heart pacemaker in size. The operation can take from one to three hours to complete and the electrodes are attached to the stomach wall using laparotomy or laparoscopy. Once the electric stimulator is in place under the skin in the abdominal wall, the lead wires are attached to the neurostimulator. The patient will usually remain in the hospital anywhere from one to five days depending on how well they are responding to the procedure and any of their pre-existing health conditions.

The post-implant procedures involve ongoing adjustments to the electrical device to keep it working at an optimal level. These adjustments can be performed in a non-invasive manner in an outpatient facility. The follow up for this procedure is from 6 to 12 months.

What Are the Possible Risks and Complications?
Before signing on for a gastric pacemaker, you should be fully aware of all of the possible side effects and complications.

Risks of Surgery

As with any surgical procedure there are always going to be risks. With this procedure, you are looking at the following risks, side effects, and complications:

• Infection


• Pain where the surgery was performed


• Bleeding


• An allergic reaction to the materials that were implanted


• Neurologic complications that could be temporary or permanent


• Bruising where the device has been implanted

Possible Side Effects

• Pain in the abdomen


• Problems swallowing


• Dehydration


• Gastrointestinal reactions


• Complications from the feeding tube


• Complications from the diabetes


• The device may stop working on your symptoms

Possible Device Complications

• You could suffer from an infection, pain or healing may be delayed in the area where the gastric electrical stimulation device has been implanted.


• The parts from the device could come through the skin in your abdomen resulting in an infection and/or a scar.


• If the neurostimulator is or becomes defective, a second operation would be required to remove it and replace it with another device.


• Your body could reject the device as being a foreign object or you may suffer from an allergic reaction.


• Some of your tissues could become damaged from the settings of the stimulation or if any of the parts of the device do not operate properly.


• You could suffer from a perforation to your stomach from the lead; this would require additional surgery.

Gastric Pacemaker

Gastric Pacemaker






Under normal condition, there would be proper muscle movements in the stomach to complete the process of digestion and expulsion properly. But certain conditions like gastroparesis can seriously affect the normal muscle movement in the stomach causing vomiting, indigestion and problems of bowel movement. Without proper movement of muscles, complete emptying of bowel is not possible. It can also alter normal levels of blood sugar and nutrition. People with prolonged diabetes are prone to develop gastroparesis.

Oral medications can be given for treating this condition but in some cases medications cannot provide relief. In such cases, an electrical device called gastric pacemaker is kept inside the stomach for sending electrical impulses that stimulates proper muscular movement giving considerable relief to the patients from various symptoms.

Gastroparesis Symptoms :

Improper muscular movement in the stomach can cause symptoms like nausea, vomiting, bloated sensation and mild to moderate stomach pain. This can cause improper absorption of nutrients resulting in Weight Loss. Due to the feeling of “fullness” in the stomach there would be no appetite. There would not be complete emptying of bowel resulting in mixing of toxins in the blood.

Gastroparesis Causes :

Prolonged diabetes can cause restricted mobility of muscles in the stomach. Some people can develop gastroparesis due to neurological diseases or metabolic problems. For many people, there is no cause (idiopathic) for gastroparesis.

Treatment :

In the initial stages medications are given to accelerate regular muscle movement in the stomach. In severe case of symptoms like severe vomiting and weight loss, a feeding tube is inserted into the stomach to ensure that the patient gets proper nutrition. Continuous lack of nutrition can cause serious problems like dehydration and malnutrition.

Not all the patients are suitable Candidates for getting gastric pacemaker. Cases that are not responding to medical treatment and patients with severe symptoms are considered for implantation surgery of pacemaker inside the stomach. Using minimal invasive procedures, the surgeon would implant a small electrical device called gastric pacemaker in the stomach which triggers the normal muscle movement thus reducing the symptoms.

Procedure :

Gastric pacemaker implant is done as in-patient treatment and requires hospitalization. Routine blood tests and other tests are done before the day of surgery. The patient will be explained about the process of surgery well in advance and about what one can expect after the implant surgery. The patient is stabilized under general anesthesia and the surgeon would make small incision in the stomach.

Gastric pacemaker is about 2-2.5 inches long and it consists of two small electrodes for producing electrical impulses. Through the incision the surgeon would carefully implant the pacemaker beneath the skin in the stomach. The neuro-stimulator is placed beneath the rib cage and just above the stomach belt line. The surgery may last from 1-3 hours depending on the health condition of the patient. The patient’s condition will be closely monitored for the next few days.

Follow Up :

Symptoms like vomiting and bloated feeling will reduce gradually and most of the patients show remarkable improvement in about 3 months after surgery. They should follow the instructions of the doctor in making follow-up visits to the hospital. Gastric electrical stimulation shortly called as GES triggers production of mild electrical impulses in the lower part of the stomach thus stimulating the nerves. It helps in contracting the stomach muscles thus relieving the symptoms of recurrent vomiting and bloated feeling. The battery of gastric pacemaker may lasts for about 10 years.

Before the Surgery :

Temporary stimulator is kept in the stomach of the patient by endoscopy to test whether gastric stimulator can be implanted permanently. The other end of electrode is passed though nose and connected with the same GES device kept externally. The patient can notice reduction of symptoms even with temporary electrical stimulator. The end of electrodes is attached to the abdominal wall under the skin of the patient. This gastric pacemaker acts very much like that of cardiac pacemaker that regulates the function of your heart. Functioning of GES can be adjusted by your doctor in non-invasive procedure. After the surgery, the stimulator is turned on and in most of the patients serious symptoms will reduce drastically. However for some patients, it may take 6-8 months for the therapy to take effect.

Risk :

Like many other surgical procedures, gastric pacemaker surgery also carries some risk. Generally it is considered safe procedure, but in rare cases infection can occur. In very rare instance the lead electrode may perforate through the stomach wall causing injury or bleeding. In that case the pacemaker has to be removed. You have to follow the instructions of your doctor after operation and should avoid stressful activities. And the patient cannot undergo MRI scanning after getting implanted with gastric pacemaker.