Long Term Efficacy of Intrapyloric Botulinum Toxin Injection in Patients with Gastroparesis
Bibliographic record
Abstract
Purpose: Pyloric dysfunction or pylorospasm is thought to play a role in gastroparesis. Observational studies have suggested that intrapyloric botulinum toxin injection (Botox) improves gastric emptying and symptoms in patients with gastroparesis. However, recent controlled trials have failed to demonstrate the efficacy of this therapy. To date, there has been no long term data published. Purpose of this study: To review the long term data from one gastroenterologist who follows gastroparesis patients receiving regular intrapyloric Botox injections. Methods: A total of 10 patients with gastroparesis (mean age 48, range 32-64, 6 with diabetes mellitus, 2 with connective tissue diseases and 2 with idiopathic gastroparesis) were followed for an average of 2.3 years (0.5-3.8). This included all patients who received Botox injections between December 2004 and June 2009. These patients all had ongoing symptoms despite optimal medical management, which included 20 to 30mg domperidone qid. They received an average of 5 injections (range 1-12) of intrapyloric Botox, at a dose of 200 units each time. Injections were given at an average interval of 213 days (range 78-579 days) or 7.1 months; this interval being determined by the recurrence of symptoms. Results: Symptoms were evaluated using a global assessment scale. Seven patients saw an improvement in their symptoms 6 weeks post-injection. The 3 non-responders were all on narcotics for chronic pain issues. Among those who responded, patients reported an average symptom severity of 8.9/10 (7-10) immediately prior to treatment, and of 3.2/10 (2-5) 6 weeks after treatment. In terms of individual symptoms, the following were assessed before and after Botox: frequency of early satiety (7/10 to 2.2/10), bloating (8.8/10 to 3.6/10), postprandial nausea (9.2/10 to 3.2/10), vomiting (8.2/10 to 1.4/10), anorexia (8.4/10 to 3.2/10) and postprandial epigastric pain (8.2/10 to 2/10). Conclusion: Although intrapyloric botulinum toxin injection does not relieve symptoms in all patients with gastroparesis, it does provide relief in select patients. In this study, 70% of patients saw improvement in symptoms post-injection.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".