Korean J Gastrointest Endosc.  2004 Aug;29(2):70-74.

Pyloric Injection of Botulinum Toxin for Treatment of Diabetic Gastroparesis: A Report of Four Cases

• Kim MS
• Lee YC
• Park H
• Lee JE
• Jeong YS
• Park JK
• Ahn CW
• Lee HC

Abstract

Gastroparesis is a disorder of gastric motility that results in delayed gastric emptying. Up to 58% of patients with diabetes mellitus may have diabetic gastroparesis, a syndrome characterized by nausea, vomiting, early satiety, and bloating. The pathophysiology of this disorder is not completely understood, but it is believed to include fundic dysaccommodation, a decrease in gastroduodenal pressure gradient and antral hypomotility. In addition to antral and fundic dysfunction, patients with diabetes may typically have pyloric dysfunction or spasm. Treatment consists of a change in diet to small volume, frequent meals and the use of the prokinetic agents. This case report describes the four patients with severe diabetic gastroparesis whose symptoms persisted despite of dietary changes and the use of prokinetic agents in high doses. All of them were treated with pyloric injection of botulinum toxin and three had significant symptomatic and scintigraphic improvement.

Keyword

Diabetic gastroparesis; Pylorus; Botulinum toxin

MeSH Terms

Botulinum Toxins*
Diabetes Mellitus
Diet
Gastric Emptying
Gastroparesis*
Humans
Meals
Nausea
Pylorus
Spasm
Vomiting
Botulinum Toxins