In June, surgeons implanted a pacemaker in a 16-year-old patient with gastroparesis, a debilitating stomach condition that affects the way the body processes food. This is the first time the procedure has been performed in a child at Nationwide Children’s Hospital, which is now one of only a handful of institutions across the country offering this type of treatment in children.
Gastroparesis is a condition where the stomach contracts less often and less powerfully, causing food and liquids to stay in the stomach for a long time. In as many as 60 percent of children with gastroparesis, the cause is not known. The condition often leaves children feeling constantly bloated and nauseated and can result in malnourishment and significant weight loss. In severe cases, symptoms may prevent children from attending school or taking part in other daily activities.
The pacemaker is inserted into the abdomen, with electrical wires leading to the stomach. It sends electrical impulses to stimulate the stomach after eating.
"The pacemaker is surgically implanted under the skin and is connected to two electrodes placed on the stomach wall. It tells the stomach to empty at a certain frequency. The initial settings are fairly low and, as with a pacemaker in the heart, we can change the settings as needed,” explained pediatric surgeon Steven Teich, MD, surgical director of the Bariatric Surgery Program at Nationwide Children’s Hospital and clinical assistant professor of surgery at The Ohio State University College of Medicine. “It empties the stomach, alleviating bloating, vomiting and nausea.”
Gastroenterology, Hepatology and Nutrition at Nationwide Children's Hospital is one of the leading programs in the country in the field of diagnosing and treating gastrointestinal motility problems in children. It is the only children’s hospital in the nation that offers the full spectrum of treatment options for motility disorders, including diagnosis, medications, endoscopic procedures, surgical options, pacemakers and follow up care.
Pacemakers have been used for years in adults with delayed gastric emptying. Nationwide Children’s received IRB approval to implant the device in children as a humanitarian device exemption (HDE), and although this is a new procedure in children and adolescents, doctors at Nationwide Children’s say the early results are promising.
“In patients who have received this type of treatment, nearly all symptoms were resolved within two weeks,” said pediatric gastroenterologist Hayat Mousa, MD, medical director of the Motility Center at Nationwide Children’s Hospital and associate professor of Clinical Pediatrics at The Ohio State University College of Medicine. “Previous treatment options, including medications, have been much less effective.”