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Review
. 2019 Jan;29(1):97-106.
doi: 10.1016/j.giec.2018.08.007. Epub 2018 Sep 28.

Botulinum Toxin Injection for Treatment of Gastroparesis

Trisha S Pasricha  1 , Pankaj J Pasricha  2
Affiliations
Review

Botulinum Toxin Injection for Treatment of Gastroparesis

Trisha S Pasricha et al. Gastrointest Endosc Clin N Am. 2019 Jan.

Abstract

Refractory gastroparesis is among the most difficult therapeutic challenges in gastroenterology. Pyloric dysfunction has been described in a subset of patients with gastroparesis, prompting experimentation with botulinum toxin injections into the pylorus, which is relatively safe and has been successfully used in other gastrointestinal disorders. However, causality between pyloric dysfunction and symptoms of gastroparesis has never been demonstrated. Although several open-label studies showed initial promise, 2 randomized clinical trials failed to elicit a difference in clinical outcomes in botulinum toxin versus placebo. Based on current evidence, further use of botulinum toxin for gastroparesis is discouraged outside of a research trial.

Keywords: BOTOX; Botulinum neurotoxin; Gastroparesis; Pyloric dysfunction; Pylorospasm.

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