SAN FRANCISCO, May 23 (UPI) -- A new, implantable electronic device that operates like a heart pacemaker could bring relief to thousands of people suffering from diseased guts, a pioneer in the field predicted late Wednesday.
"It's the beginning of a new era. It's the beginning of 'gut pacing,' where cardiac pacing was 20 years ago," said, Dr. Richard W. McCallum, professor of medicine, chief of gastroenterology and hepatology, and director of the Center for GI Motility Disorders at the University of Kansas Medical Center in Kansas City, Kan.
McCallum told United Press International medical treatment entered a new age of gastric electrical stimulation to help people he describes as "gastric cripples."
McCallum made his prediction at the Digestive Disease Week annual conference, where some of his pioneering work, including the Enterra Therapy gastric electric stimulation system, was featured.
At least 700,000 people in the United States are afflicted with vomiting or nausea so intrusive it has forced many of them to put both careers and personal lives on hold. Lacking technological fixes, there is often nothing else that can be done for them.
The cause of their suffering might stem from nerve deterioration caused by type 1 diabetes or surgical procedures that accidentally damaged the gastric nerves or nerves not properly formed at birth, for example.
McCallum said such patients would be eligible for the Enterra Therapy implants and other devices he has helped develop at KUMC and for Medtronic, a leading maker of medical equipment.
In most cases, the devices aid malfunctioning or damaged stomach nerves by sending a steady flow of very short pulses of electrical current. The pulses are 330 microseconds or thousandths of a second each, 12 times each minute.
The implants have been popularly, though inaccurately, described as stomach pacemakers, McCallum said. He imagines expanding the use of his devices to include other forms of chronic nausea and vomiting such as those caused by chemotherapy or radiation therapy used in cancer treatments.
Surgery to install the implants costs $20,000 to $25,000, but results in average savings of $64,000 in hospitalization costs the year following implantation.
The implants are not perfect, McCallum said because they do not cause the stomach to empty, a problem for which researchers as yet have no answers. Even so, about 75 to 80 percent of patients feel substantial and clinical improvement -- sufficient enough people who respond to the implants are able to resume normal lives.
Who will respond to the treatment remains a mystery, however, he said. On average, 20 percent do not respond.
The gastric implantation field is young, with only 300 procedures completed since 1994. The largest number of these have been done at KUMC and most of the rest have been done at just three other centers -- Temple University in Philadelphia, Virginia Mason Clinic in Seattle and University of Mississippi in Jackson.
McCallum said he has begun working on an implantable network of electrical stimulation circuitry to provide full coverage throughout the GI tract -- not just for the stomach -- to those who could benefit. He calls it "multipoint pacing," which would distribute coordinated, programmable electrical pulses to points throughout the gut down to the colon as needed.
For people suffering from these crippling gastric problems, "There's enough evidence there is nothing you can do for these guys. These guys are truly crippled," agrees Dr. Roy Wong, chief of gastroenterology at Walter Reed Army Medical Center, and director of the division of digestive diseases for the Uniformed Services University of the Health Sciences.
Wong told UPI he is impressed enough by McCallum's technology that he expects to have staff trained on the system by the end of the year.
