Botox

It has been found that some patients with gastroparesis suffer from spasms of the pyloric sphincter. The pyloric sphincter, or pylorus, is a ring of muscles that helps to control the passage of food from the stomach into the duodenum (the first part of the small intestine). If the pyloric muscles are in spasm, they can contribute to delayed gastric emptying. When Botox (botulinum toxin) is injected into the pyloric muscles, the sphincter should relax and allow more food to pass through. The trials of this treatment approach have had varying results, with some patients demonstrating a decrease in symptoms for 1-6 months, but controlled trials (the highest level of evidence) not showing significant effects. This treatment is usually only recommended if other approaches have not been successful, and further studies are being conducted on the temporary improvements that Botox may have on gastric emptying. A single trial of Botox may be used to see if a patient belongs to a subgroup of patients who may respond to this treatment.