A meta-analysis showed that for children with refractory upper gastrointestinal symptoms, both with and without gastroparesis, intrapyloric Botulinum Toxin A (IPBTI) is safe and can effectively provide transient symptomatic relief. Yamen Ezaizi et al. set out to evaluate the effectiveness of IPBTI in children.

To find out children (under 18 years of age) who received an esophagogastroduodenoscopy with IPBTI for persistent upper gastrointestinal tract symptoms, electronic health records were retrospectively examined. Children with and without gastroparesis were included, and children with symptoms that may be explained by mucosal illness, gastrointestinal obstruction, or gastrointestinal surgery were excluded. The study results were included in a meta-analysis.

There were 20 children with a mean age of 9.7 years, suffering from upper gastrointestinal symptoms who underwent IPBTI. Out of 20 children, 17 children underwent gastric emptying scintigraphy. Only 9 (53%) exhibited gastroparesis. Ten kids (50 %) reportedly responded to IPBTI. The presence of gastroparesis in the incorporated children had no effect on how they responded to IPBTI.

As found, 4 children who responded to the first injection had repeated IPBTI; none of the four reported benefit from the second IPBTI. In the cohort, there were no IPBTI complications recorded. Regardless of the existence of gastroparesis, 68% of patients had a response to IPBTI, according to the meta-analysis; 66 % of subjects with gastroparesis exhibited a response to IPBTI. Children can safely get an intrapyloric injection of Botulinum Toxin A, which can provide momentary relief for those with refractory upper gastrointestinal symptoms, both with and without gastroparesis.