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2015 ; 7
(8
): 790-8
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Endoscopic botox injections in therapy of refractory gastroparesis
#MMPMID26191343
Ukleja A
; Tandon K
; Shah K
; Alvarez A
World J Gastrointest Endosc
2015[Jul]; 7
(8
): 790-8
PMID26191343
show ga
Gastroparesis (GP) is a common disease seen in gastroenterology practice
particularly in western countries, and it may be underdiagnosed. The available
drug therapies for this condition are quite disappointing. Botulinum toxin type A
(BT) has been found to be effective therapy in various spastic disorders of
smooth muscle of gastrointestinal tract. However, the benefits of BT injections
in GP have been unclear. Several retrospective and open label studies have shown
clinical advantages of intrapyloric Botulinum toxin type A injections, while two
small randomized trials did not show positive results. Therefore, the available
published studies yielded conflicting results leading to fading out of botox
therapy for GP. We recognize possible clinical benefit of BT injections without
any disadvantages of this treatment. We are calling for revisiting the endoscopy
guided botox therapy in refractory GP. In this review we discuss important
features of these studies pointing out differences in results among them.
Differences in patient selection, doses and method of administration of botox
toxin in the prior studies may be the cause of conflicting results. The mechanism
of action, indications, efficacy and side-effects of BT are reviewed. Finally, we
recognize limited evidence to recommend BT in GP and calling attention for future
research in this field since no advances in drug management had been made in the
last two decades.