Comparison of Symptom Control in Pediatric Gastroparesis Using Endoscopic Pyloric Botulinum Toxin Injection and...

Area of Science:

• Pediatric Gastroenterology
• Endoscopic Interventions
• Gastrointestinal Motility Disorders

Background:

• Gastroparesis in children presents significant management challenges.
• Endoscopic therapies are increasingly explored for pediatric gastroparesis.

Purpose of the Study:

• To compare the safety and efficacy of endoscopic intrapyloric botulinum toxin injection versus pyloric dilatation in pediatric gastroparesis.
• To evaluate recurrence rates and long-term outcomes of these endoscopic interventions.

Main Methods:

• Retrospective, multicenter study including 24 pediatric patients (median age 2.5 years) treated between 2010-2018.
• Analysis of 46 endoscopic procedures, comparing botulinum toxin injection and pyloric dilatation.
• Data collected on intervention success, recurrence, complications, and follow-up duration.

Main Results:

• Overall, 76% of interventions were successful, with no significant difference in efficacy between botulinum toxin and pyloric dilatation.
• A high recurrence rate of 57% was observed, with a median time to recurrence of 3.7 months.
• No complications were reported, indicating a favorable safety profile for both methods.

Conclusions:

• Endoscopic management of pediatric gastroparesis using balloon dilatation or botulinum toxin is safe.
• These endoscopic interventions demonstrate partial short-term efficacy, but frequent symptom recurrence is common.
• Repetition of interventions is often required due to high recurrence rates in children with gastroparesis.