Pyloric Injection of Botulinum Toxin for Treatment of Diabetic Gastroparesis: A Report of Four Cases.
- Author:
Min Su KIM
1
;
Yong Chan LEE
;
Hyojin PARK
;
Jung Eun LEE
;
Yon Soo JEONG
;
Jong Kwan PARK
;
Chul Woo AHN
;
Hyun Chul LEE
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. hjpark21@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Diabetic gastroparesis;
Pylorus;
Botulinum toxin
- MeSH:
Botulinum Toxins*;
Diabetes Mellitus;
Diet;
Gastric Emptying;
Gastroparesis*;
Humans;
Meals;
Nausea;
Pylorus;
Spasm;
Vomiting
- From:Korean Journal of Gastrointestinal Endoscopy
2004;29(2):70-74
- CountryRepublic of Korea
- Language:Korean
-
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.
