Endoscopic pyloric injection of botulinum toxin A for the treatment of refractory gastroparesis

Bromer, Matthew Q.; Friedenberg, Frank K.; Miller, Larry S.; Fisher, Robert S.; Swartz, Kenneth P.; Parkman, Henry P.

doi:10.1016/s0016-5107(05)00328-7

Cited by 182 publications

(119 citation statements)

References 28 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…The response rate is 43% and it lasts about 5 months. However the safety of botulinum therapy is established but still more clinical trial are needed to prove its clinical efficacy in the treatment of Gastropariesis [33].…”

Section: Treatmentmentioning

confidence: 99%

Functional Dyspepsia: An Unresolved Issue

Mehboob¹

2015

Intern Med

View full text Add to dashboard Cite

Functional dyspepsia (FD) is one of the commonest medical problems which affect the quality of life. Due to its global presentation variety of symptoms recorded, therefore no global consensus developed. The recorded symptoms of functional dyspepsia are nonspecific and the pathophysiology is diverse. The role of genetics in the susceptibility of FD is still not well established. The last Rome III criteria defined the FD as symptoms of epigastric pain or discomfort, early satiety and postprandial fullness with in the last three months with symptoms not less than six months. Patient cannot have any evidence of structural disease and predominant Gastro esophageal reflux symptoms. Failure to respond to 'test and treat approach' is also categorize as FD. A universally effective treatment for functional dyspepsia remains elusive. The purpose of this paper is to highlight the details in perspective of functional dyspepsia.

show abstract

Section: Treatmentmentioning

confidence: 99%

Functional Dyspepsia: An Unresolved Issue

Mehboob¹

2015

Intern Med

View full text Add to dashboard Cite

show abstract

“…Several uncontrolled case series have reported reduced symptoms and acceleration of gastric emptying after botulinum toxin treatment [112][113][114] . The largest series reported 63 highly selected patients with primary idiopathic gastroparesis, 43% of whom responded symptomatically with mean response duration of 5 mo [115] . A double-blind controlled trial found no efficacy of botulinum toxin over placebo [116] .…”

Section: Endoscopic Treatmentmentioning

confidence: 99%

Gastroparesis: Current diagnostic challenges and management considerations

Waseem¹,

Moshiree²,

Draganov³

2009

WJG

139

View full text Add to dashboard Cite

Gastroparesis refers to abnormal gastric motility characterized by delayed gastric emptying in the absence of mechanical obstruction. The most common etiologies include diabetes, post-surgical and idiopathic. The most common symptoms are nausea, vomiting and epigastric pain. Gastroparesis is estimated to affect 4% of the population and symptomatology may range from little effect on daily activity to severe disability and frequent hospitalizations. The gold standard of diagnosis is solid meal gastric scintigraphy. Treatment is multimodal and includes dietary modification, prokinetic and anti-emetic medications, and surgical interventions. New advances in drug therapy, and gastric electrical stimulation techniques have been introduced and might provide new hope to patients with refractory gastroparesis. In this comprehensive review, we discuss gastroparesis with emphasis on the latest developments; from the perspective of the practicing clinician.

show abstract

“…This treatment is most effective in elderly as symptomatic relief can last up to one to two years with a single injection [53].In a study of patients with diabetic gastro paresis, botulinum toxin injection to the pylorus was found to relieve symptoms of gastro paresis [54]. In a review of the use of botulinum toxin in a large number of patients with gastro paresis it was found that 43% had a response to botulinum toxin treatment that lasted approximately up to 5 months, male gender was associated with a response and presence of vomiting as a major symptom predicted no response to botulinum toxin injection [55]. In a meta analysis of three randomized control trials, it is seen that botulinum toxin is as effective as glyceryl trinitrate for the management of chronic anal fissure and is associated with a lower complication rate.…”

Section: Gastrointestinal Disordersmentioning

confidence: 99%

Therapeutic Application of Botulinum Toxin in Clinical Practice

Dash¹,

Araf²

2009

TOGMJ

View full text Add to dashboard Cite

Botulinum toxin, one of the most potent toxins known, is produced by Clostridium botulinum. It causes a temporary paralysis of muscles by inhibiting vesicular release of acetylcholine in neuromuscular junction and synaptic transmission at cholinergic nerve terminals and causes a temporary paralysis of muscles. Since the approval of botulinum toxin A by FDA for strabismus and blepharospasm in 1989 and botulinum toxin B for cervical dystonia in 2000, its therapeutic uses are expanding. To date, both the serotypes A and B have been used therapeutically. These include various dystonic movement disorders, lacrimal hypersecretion, hyperhydrosis, overactive bladder syndromes both neurogenic and idiopathic, prostatic hyperplasia, various gastrointestinal disorders, headache syndromes like migraine and various spastic disorders. Botulinum toxin does not correct the underlying pathology but only produces clinically symptomatic improvement. The duration of improvement and the percentage of improvement vary between different studies due to differences in doses used; different techniques used for injections and also the dilutions. Still more trials are required to explore newer indications of its use, to find out the exact effective doses, dilutions and techniques, so as to have a prolonged clinical improvement. Though it has a good safety profile, complications are related to chemodenervation of adjacent muscles and injection techniques. This article provides an update on different uses of botulinum toxin in medicine.

show abstract

Endoscopic pyloric injection of botulinum toxin A for the treatment of refractory gastroparesis

Cited by 182 publications

References 28 publications

Functional Dyspepsia: An Unresolved Issue

Functional Dyspepsia: An Unresolved Issue

Gastroparesis: Current diagnostic challenges and management considerations

Therapeutic Application of Botulinum Toxin in Clinical Practice

Contact Info

Product

Resources

About