Pyloric botulinum toxin injection has been reported to improve the symptoms in children with delayed gastric emptying. A study was thus conducted to evaluate the clinical response to combined endoscopic intra-pyloric botulinum toxin injection and pyloric balloon dilation (IPBT-BD) in patients experiencing dyspepsia.

Investigators analyzed the electronic medical records to obtain data on demographics, symptoms, and follow-up, for patients with dyspepsia. Cases were characterized as those who underwent IPBT-BD besides ongoing management. Controls received pharmacotherapy, behavioral intervention, or dietary management only. Clinical response was described by no change, partial, or complete improvement in symptoms within 12 months. Investigators used propensity score matching based on age, gender, and symptom duration in order to pair cases and controls.

Seventy nine cases and 83 controls were identified. After propensity matching, a total of 63 patients were included in each group. The mean age for cases was 14.5 ± 3.9 years. Around 83% of 46 cases and 94% of 49 controls who underwent scintigraphy scans were found to have delayed gastric emptying.

After matching, 76% of the cases had partial or complete improvement, in comparison with 49% of the controls within 12 months (P = 0.004). Younger children had a more favorable response to the procedure (P = 0.08).

To conclude, combined IPBT-BD besides pharmacotherapy, behavioral, or dietary management, was more beneficial that these modalities alone, and the favorable response persisted for 12 months.

Source: Santucci NR, Kemme S, El-Chammas KI, et al. Outcomes of combined pyloric botulinum toxin injection and balloon dilation in dyspepsia with and without delayed gastric emptying. Saudi J Gastroenterol. 2022 Jan 25.