Endoscopic botox injections in therapy of refractory gastroparesis

doi:10.4253/wjge.v7.i8.790

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Endosc. Jul 10, 2015; 7(8): 790-798
Published online Jul 10, 2015. doi: 10.4253/wjge.v7.i8.790

Endoscopic botox injections in therapy of refractory gastroparesis

Andrew Ukleja, Kanwarpreet Tandon, Kinchit Shah, Alicia Alvarez

Andrew Ukleja, Kanwarpreet Tandon, Kinchit Shah, Alicia Alvarez, Department of Gastroenterology, Cleveland Clinic Florida, Weston, FL 33331, United States

Author contributions: Ukleja A contributed to topic selection, title selection, manuscript drafting, writing, critical revision and editing; Tandon K, Shah K and Alvarez A contributed to manuscript drafting, writing and editing and table formulation.

Conflict-of-interest statement: Andrew Ukleja, Alicia Alvarez, Kanwarpreet Tandon, Kinchit Shah are employees of Cleveland Clinic Florida: No financial disclosure or conflict of interest.

Correspondence to: Andrew Ukleja, MD, Department of Gastroenterology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL 33331, United States. uklejaa@ccf.org

Telephone: +1-954-6595646 Fax: +1-954-6595647

Received: December 31, 2014
Peer-review started: January 1, 2015
First decision: January 20, 2015
Revised: January 31, 2015
Accepted: May 5, 2015
Article in press: May 8, 2015
Published online: July 10, 2015
Processing time: 195 Days and 9 Hours

Core Tip

Core tip: Refractory gastroparesis (GP) has been identified as a chronic debilitating disease. After failure of diet and prokinetic drugs for treatment of refractory GP only surgical options are left. Because of the limited available treatment options and frequent failure of medical therapy, botulinum toxin (BT) injection in the pylorus might offer clinical value in GP. Currently available evidence is not strong enough to support the recommendation of this procedure in all patients with refractory GP; but promising results have been seen as most patients have noticed symptomatic improvement. Although BT injections were successful in some GP patients, the role of BT remains undetermined. We addressed the position of botulinum toxin in the spectrum of available treatments for refractory GP. Continuing other treatment modalities after BT may improve the results.