Impact of Gastric Electrical Stimulation on Gastrointestinal and Non-Gastrointestinal Somatic Symptoms

Gastric electrical stimulation (GES) improves refractory nausea and vomiting in children, but the impact on non-gastrointestinal symptoms remains unclear. We identified patients < 21 years old treated with GES between 2016 and 2024. Patients completed the Symptom Monitor Worksheet (SMW), Pediatric Quality of Life Inventory (PedsQL), and Children's Somatic Symptoms Inventory (CSSI) at baseline before GES and at 14 days, 2, 6, and 12 months follow-up. We used a linear mixed effects regression model and a random intercept for each subject to capture individual variability in assessment of score changes during the first year and to evaluate differences in CSSI based on symptom response defined as > 1 point improvement in average SMW score from baseline to last follow-up. We included 34 patients (79% female, mean age 15.4 years): 97% had gastroparesis, 50% functional dyspepsia, 47% postural orthostatic tachycardia syndrome, and 67% a history of anxiety/depression. After 1 year of GES treatment, there was sustained improvement in SMW and PedsQL. CSSI improved over the first 6 months and remained improved numerically at the end of the year, but this was not statistically significant. Sixteen patients met criteria for greater response and 18 for lesser response based on degree of SMW improvement. Baseline CSSI, including GI and non-GI subsets, was similar between patients with greater and lesser response to GES, and both experienced transient improvement in the non-GI somatic symptoms. Children treated with GES experienced sustained improvement in GI symptoms and quality of life, but only transient improvement in non-GI somatic symptoms.