Influence of intrapyloric botulinum toxin injection on gastric emptying and meal-related symptoms in gastroparesis patients.

Abstract

BACKGROUND:

Recent observations in limited numbers of patients suggest a potential benefit of intrapyloric injection of botulinum toxin in the treatment of gastroparesis.

AIM:

To characterize the effect of botulinum toxin on solid and liquid gastric emptying and on meal-related symptoms.

METHODS:

In 20 gastroparesis patients (17 women, mean age 37 +/- 3 years, three diabetic and 17 idiopathic), gastric emptying for solids and liquids was measured before and one month after intrapyloric botulinum toxin 4 x 25 units. Before the meal and at 15-min intervals up to 240 min postprandially, the patient graded the intensity of six gastroparesis symptoms, and a meal-related severity score was obtained by adding all intensities. Data (mean +/- S.E.M.) were compared using paired Student's t-test.

RESULTS:

Treatment with botulinum toxin significantly enhanced solid (t(1/2) 132 +/- 16 vs. 204 +/- 35 min, P < 0.05) but not liquid (92 +/- 10 vs. 104 +/- 11 min, N.S.) emptying. This was accompanied by a significant decrease in cumulative meal-related symptom score (73.5 +/- 16.3 vs. 103 +/- 17.1 baseline, P = 0.01) as well as individual severity scores for postprandial fullness, bloating, nausea and belching (all P < 0.001, two-way anova).

CONCLUSIONS:

Botulinum toxin improves solid but not liquid gastric emptying in gastroparesis, and this is accompanied by significant improvement of several meal-related symptoms.

• Authors: J Arts, S van Gool, P Caenepeel, K Verbeke, J Janssens, J Tack
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 24 Issue 4 Pg. 661-7 (Aug 15 2006) ISSN: 0269-2813 [Print] England
• PMID: 16907899 (Publication Type: Journal Article)

Chemical References

• Anti-Dyskinesia Agents
• Botulinum Toxins

Topics

• Adult
• Anti-Dyskinesia Agents (therapeutic use)
• Botulinum Toxins (therapeutic use)
• Female
• Gastric Emptying (drug effects)
• Gastroparesis (drug therapy)
• Humans
• Male
• Postprandial Period (physiology)
• Treatment Outcome