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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.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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
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.