Botox Alleviates Nausea in Kids With Gut-Brain Disorder

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In kids suffering from gut-brain interaction disorders (DGBI), injecting Botulinum toxin (Botox) into the pylorus, the sphincter where the stomach connects to the small intestine, during an endoscopy procedure, has been found to alleviate chronic nausea and vomiting, stated study from Ann & Robert H. Lurie Children's Hospital of Chicago ().

These debilitating symptoms not attributed to a defined illness have previously been called functional gastrointestinal disorders before the newer DGBI classification. The study's findings point to a novel understanding of the condition's pathology - pylorus that is failing to relax and allow food to effectively pass into the small intestine resulting in symptoms of nausea, vomiting, stomach fullness (early satiety), and bloating. Results were published in the Journal of Pediatric Gastroenterology and Nutrition.

Pyloric Dysfunction Identified as a Potential Cause of Chronic Nausea and Vomiting

"Our results suggest that chronic nausea and vomiting might be caused by pyloric dysfunction, rather than abnormal peristalsis, which is the rhythmic contraction and relaxation of digestive tract muscles needed to move foods and liquids through the gastrointestinal system," said lead author Peter Osgood, MD, gastroenterologist at Lurie Children's and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "This is a paradigm shift in our understanding of mechanistic pathology. Importantly, it opens the door to a more targeted use of Botox specifically in children who are found to have pyloric dysfunction during endoscopy, and for whom the current medications are not effective."

‘The research provides a more precise use of Botox for children with pyloric dysfunction during endoscopy, especially when medications are ineffective. #botox #digestivehealth #gutbrain ’

In the study that included 25 patients, Dr. Osgood and colleagues looked for evidence of abnormal peristalsis. They found that in the majority of patients, this process was normal. They also found that most patients responded favorably to pyloric Botox injection, even when they did not have delayed gastric emptying.

"Pyloric dysfunction has been underexplored in the context of chronic nausea and vomiting in children," said senior author John Fortunato, Jr, MD, Director of Neurointestinal and Motility Program at Lurie Children's and Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "We are pursuing further research to better understand pyloric pathology and its response to Botox therapy. Our study is a promising first step toward offering much needed relief to children suffering from these challenging symptoms."

Reference:

1. Intrapyloric Botulinum Toxin Injection for Refractory Nausea and Vomiting in Pediatric Patients - (https:journals.lww.com/jpgn/abstract/9900/intrapyloric_botulinum_toxin_injection_for.504.aspx)

Source: Eurekalert