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CompletedNCT03123809GES+PPUpdated May 15, 2025

Gastric Electrical Stimulation (GES) and Pyloroplasty for the Treatment of Gastroparesis

An interventional study of Gastric Electrical Stimulation (GES) System in Gastroparesis, sponsored by Texas Tech University Health Sciences Center, El Paso. Completed at 1 site in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-05-15.

Sponsored by Texas Tech University Health Sciences Center, El Paso · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
44
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

Gastroparesis (GP) is describing a condition when stomach does not empty as fast as it should. This fact creates the situation, when food stays in the stomach for a long time and it causes symptoms of nausea, vomiting, loss of appetite, bloating, inability to finish normal size meal and abdominal pain. There are not many drugs available to treat this condition and majority of gastroparetic patients are not responding well to them after they are on it for some time. Many investigators are able to implant Gastric Stimulator System (GES) under FDA approved status of Humanitarian Device Exemption (HDE) definition. In the last few years it became possible to add another surgical procedure, which is called pyloroplasty (making bigger opening on the end of stomach), may help even more as it is also increasing the rate of the emptying of the stomach. Therefore this study is proposing to evaluate if GES in combination with pyloroplasty is much better than pyloroplasty alone. For this reason, two of these procedures will be introduced surgically at the same time, but GES devices will not be turn ON in half of these participants for 3 months. After that time all subjects will have their devices turned ON. All subjects will be asked to evaluate their symptoms of gastroparesis and their quality of life during clinical visits, and investigators will conduct pathological analyses of tissue obtained during surgery.

Read the detailed description

GES system (Enterra Therapy) involves surgical implantation of a pulse generator in the abdominal wall and 2 electrodes into the muscularis propria of the stomach. Well established procedure, called pyloroplasty, will be performed during the implantation of GES system, therefore all participants will have both surgeries done at the same time. Half of them will be randomized to keep GES ON after surgery, and other half will have GES turned OFF for 3 months.

Both groups will be followed for additional 3 more months. Study related questionnaires and diagnostic/ clinical tests will be obtained at all points of interest of this study.

02

Conditions studied

  • Gastroparesis

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Keywords

  • Diabetes Mellitus
  • gastroparesis
  • gastric electrical stimulation
  • pyloroplasty
  • Idiopathic -unknown etiology
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Documented diagnosis of GP for > 1 year and refractoriness to anti-emetics and prokinetics; more than 7 emetic episodes per week;
  • Delayed GE (gastric retention greater than 60% at 2 h and/or greater than 10% at 4 h) based on a 4-h standardized radionuclide solid meal test

Exclusion criteria

Exclusion Criteria:

  • Organic or pseudo-obstruction, primary eating or swallowing disorders, positive pregnancy test result, psychogenic vomiting, peritoneal dialysis, drug dependent, morbid obesity, active malignancy
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
44 participants (actual)

Study arms

  • Active comparator
    Gastric Electrical Stimulation (GES) ON

    Gastric Electrical Stimulation (GES) system involves surgical implantation of a pulse generator in the abdominal wall and 2 electrodes into the muscularis propria of the stomach. After surgery this group of GP patients will have their GES programed and system will be turned ON for 3 months during a double-blind phase of the study. This step will be followed with additional 3 months of active stimulation (GES System will be turned ON) as it is described in the protocol.Therefore all subjects in this arm will receive overall 6 months of intervention, which will be provided by the active stimulation of GES System (GES turned ON for 6 months).

    Device: Gastric Electrical Stimulation (GES) System

  • Placebo comparator
    Gastric Electrical Stimulation (GES) OFF

    Gastric Electrical Stimulation (GES) system involves surgical implantation of a pulse generator in the abdominal wall and 2 electrodes into the muscularis propria of the stomach. After surgery this group of GP patients will have their GES programed and system will be turned OFF for 3 months.This step will be followed with additional 3 months of active stimulation (GES System will be turned ON) as it is described in the protocol. Therefore all subjects in this arm will receive first 3 months of non GES intervention (GES System OFF), and 3 following months of active intervention which will be provided by the stimulation of GES System (GES turned ON for 3 months).

    Device: Gastric Electrical Stimulation (GES) System

Interventions

  • DeviceGastric Electrical Stimulation (GES) System

    Implantable GES System will be turned ON as an active intervention providing electrical stimulation to the muscle of stomach for 6 months in patients from the first arm, versus 3 months only of active stimulation in patients who are randomized to be in the second arm of the study. GES works by utilizing following parameters: Current 5 mA; Pulse Width 330µsec; Rate 14 Hz; Time ON 0.1 sec; Time OFF 5.0 sec.

    Also known as: Enterra II Therapy System INS Model 37800;

05

What researchers measure

Primary outcomes

  1. Changes of total gastroparesis symptom scores (TSS)

    Severity and frequency of gastroparesis symptoms will be assess at baseline /surgery, after 3 months of randomized phase (GES ON or OFF), and at the end of 3 months of clinical follow up visit.

    Time frame: up to 7 months

Secondary outcomes

  1. Total Symptom Score (TSS) with severity and frequency of gastroparesis symptoms in each etiological subgroup of patients

    TSS in diabetic and idiopathic sub-group of gastroparetic patients will be compared and analyzed (if adequate number of patients will be in each subgroup)

    Time frame: Up to 7 months

  2. Associations between changes in gastric emptying and TSS

    Statistical analyses of any possible correlation between retention of GET study meal and gastroparesis symptoms will be asses at the end of randomized phase of the study.

    Time frame: Up to 7 months

  3. Percentage of changes of gastric emptying retention of the radiolabeled meal (%) at 2-4 hrs

    Scintigraphy Gastric Emptying Test (GET) will be recorded at baseline and after 3 months of randomized phase (GES ON or OFF)

    Time frame: up to 7 months

06

Study locations

1 site
  • Texas Tech University Health Sciences Center
    El Paso, Texas 79905, United States
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03123809
Lead sponsor
Texas Tech University Health Sciences Center, El Paso
Responsible party
Irene Sarosiek (Professor of Medicine, Texas Tech University Health Sciences Center, El Paso) — Principal investigator
First posted
Apr 21, 2017
Start date
Jan 10, 2017
Primary completion
Sep 15, 2023
Completion
Oct 30, 2024
Last update
May 15, 2025

Study contacts

Irene Sarosiek, MD
principal investigator · Texas Tech University Health Sciences Center

Oversight

Data monitoring committee
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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