Premium
Influence of intrapyloric botulinum toxin injection on gastric emptying and meal‐related symptoms in gastroparesis patients
Author(s) -
ARTS J.,
VAN GOOL S.,
CAENEPEEL P.,
VERBEKE K.,
JANSSENS J.,
TACK J.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.03019.x
Subject(s) - gastric emptying , gastroparesis , medicine , postprandial , meal , gastroenterology , botulinum toxin , bloating , nausea , vomiting , stomach , anesthesia , insulin
Summary 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 × 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.