Pyloric injection of botulinum toxin for treatment of diabetic gastroparesis

Dina Ezzeddine, Rajkamal Jit, Neil Katz, Narasimh Gopalswamy, Manoop S. Bhutani

Research output: Contribution to journalArticlepeer-review

155 Scopus citations

Abstract

Background: Diabetic gastroparesis is a common clinical problem. The pathophysiology includes prolonged pyloric contractions that may cause functional resistance to gastric outflow. Botulinum toxin was injected into the pyloric sphincter in an attempt to decrease pyloric resistance and improve gastric emptying. Methods: Six patients with diabetic gastroparesis and an abnormal solid phase gastric emptying study underwent upper endoscopy during which 100 units of botulinum toxin were injected into the pyloric sphincter. Gastric emptying studies were obtained at 48 hours and 6 weeks after injection. Patients were questioned about symptoms of gastroparesis, and a symptom score was obtained at baseline and at 2 weeks and 6 weeks after injection. Observations: There was a mean improvement in the subjective symptom score at 2 weeks of 55% (range 14% to 80%). This improvement was maintained at 6 weeks. There was a 52% improvement in gastric emptying at 2 and 6 weeks. Conclusion: Pyloric injection of botulinum toxin can improve symptoms and gastric emptying in patients with diabetic gastroparesis. Further evaluation of pyloric injection of botulinum toxin as a treatment for diabetic gastroparesis is warranted.

Original languageEnglish (US)
Pages (from-to)920-923
Number of pages4
JournalGastrointestinal endoscopy
Volume55
Issue number7
DOIs
StatePublished - Jun 2002
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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