P0804 - Efficacy and Safety of Bioelectrical Therapies for Gastrointestinal Motility Disorders: A Systematic Review and Meta-Analysis

Arthur CHIDI. Igbo, MD, MPH¹, Chimezirim Ezeano, MD, MPH², Angelin Raju, MD³, Maher Taha, MD⁴, Olanrewaju Adeniran, MD⁵, Albert C. Annan, MD⁶, Angel Umahi, ⁷
1Texas Health Resources HEB/Denton Internal Medicine Program, Lewisville, TX; 2Aurora Healthcare, Aurora, WI; 3Texas Health Resources HEB/ Denton, Bedford, TX; 4Texas Health Resources, Irving, TX; 5West Virginia University Morgantown, Morgantown, WV; 6Texas Health Resources HEB/Denton Internal Medicine GME, Lewisville, TX; 7University of Lancashire, Lancashire, England, United Kingdom

Introduction: Gastrointestinal motility disorders, such as gastroparesis, significantly impair quality of life, with limited effective treatments for refractory cases. Bioelectrical therapies, including gastric electrical stimulation (GES) and combined approaches with pyloric procedures, have been studied as promising interventions. This systematic review and meta-analysis evaluates their efficacy and safety in managing symptoms of gastroparesis and related disorders.

Methods: We systematically searched databases for studies (randomized controlled trials, cohort studies, and observational studies) on bioelectrical therapies (GES, GES with pyloroplasty, gastric peroral endoscopic myotomy) in patients with gastroparesis or similar motility disorders. Eligible studies (n=15) included 1,487 patients, with data on age (range 2–84 years), sex (61.8%–89.4% female), and etiologies (diabetic, idiopathic, postsurgical). Primary outcomes were changes in symptom severity (Gastroparesis Cardinal Symptom Index [GCSI] score), with secondary outcomes including gastric emptying time, quality of life (QoL), hospital admissions, and adverse events. Data were pooled using standardized mean differences and risk ratios, with heterogeneity assessed via I² statistics.

Results: Bioelectrical therapies, particularly GES, significantly reduced symptom severity (pooled GCSI score reduction: 1.2–2.5 points, 10 studies) across diverse cohorts. Combined GES and pyloric procedures showed comparable or superior outcomes, especially in diabetic and idiopathic gastroparesis. Gastric emptying improved in 60% of studies (4-hour retention decrease: 10%–30%). QoL scores (GIQLI) and hospital admission rates also improved, though adverse events (e.g., device migration, infection) occurred in 5%–15% of cases. Heterogeneity was moderate (I² = 45%–60%), reflecting variability in study design, stimulation parameters, and follow-up (6 months–17 years).

Discussion: Bioelectrical therapies, combined with pyloric interventions, demonstrate promising efficacy in symptom control for gastrointestinal motility disorders, with acceptable safety profiles. However, variability in protocols and study designs highlights the need for standardized, randomized trials to optimize treatment strategies and patient selection.

Disclosures:
Arthur Igbo indicated no relevant financial relationships.
Chimezirim Ezeano indicated no relevant financial relationships.
Angelin Raju indicated no relevant financial relationships.
Maher Taha indicated no relevant financial relationships.
Olanrewaju Adeniran indicated no relevant financial relationships.
Albert Annan indicated no relevant financial relationships.
Angel Umahi indicated no relevant financial relationships.

Arthur CHIDI. Igbo, MD, MPH¹, Chimezirim Ezeano, MD, MPH², Angelin Raju, MD³, Maher Taha, MD⁴, Olanrewaju Adeniran, MD⁵, Albert C. Annan, MD⁶, Angel Umahi, ⁷. P0804 - Efficacy and Safety of Bioelectrical Therapies for Gastrointestinal Motility Disorders: A Systematic Review and Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.