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The injection of botulinum toxin has been used to treat sphincter dysfunction in the gastrointestinal tract with limited success. Some evidence suggests that delayed gastric emptying can be improved by this approach (Gastrointest Endosc 2005; 61:833).
Investigators in Philadelphia randomized 32 patients with idiopathic or diabetic gastroparesis to injection of botulinum toxin A (200 U) or placebo into the pyloric sphincter. Both investigators and patients were blinded to the randomization scheme. One month later, patients were assessed using the Gastroparesis Cardinal Symptom Index (GCSI), the Gastroparesis Visual Analog Scale (GVAS), and evaluations of gastric emptying.
Symptom improvement (defined as ≥9-point reduction in GCSI) was seen in …