What Are The Side Effects of Botox Injections For Gastroparesis?

Many people know Botox as the miracle drug for anti-aging, especially for wrinkle treatments. However, not a lot of individuals are probably familiar with its use for various medical conditions. As a highly versatile injection, one of the novel therapeutic applications of Botox is for treating patients with gastroparesis. Unlike the conventional surgical treatments for this disorder, using Botox is minimally invasive but there are still some possible side effects and risks. 

So what side effects should you expect with Botox injections for the treatment of gastroparesis? The pyloric injection of Botox is mostly a safe procedure with a low risk for serious complications. Some of the immediate side effects that could happen post-injection are abdominal pain, chest pain, scarring, fever, difficulty swallowing, sore throat, and mild bleeding. There’s also a slight risk of allergic reactions to Botox although it’s very rare. 

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How Safe Are Botox Injections For Gastroparesis? 

For years, Botox has been a widely accepted treatment for many cosmetic and medical conditions. According to several clinical studies, the injection of botulinum toxin is safe and carries little to no risk for any adverse side effects or permanent damage to organs in the body.  

To better understand its safety and efficiency for treating gastroparesis, it’s important to know how Botox actually works as a therapeutic injection. Botox or botulinum toxin is a purified protein form derived from the bacterium clostridium botulinum. 

It’s a known neuromodulator and it acts by stopping nerve signals from interacting with muscles and inhibiting their contraction. Botox works for almost every muscle in the body so it’s also believed to be effective for treating gastric neuromuscular disorders. And one of the most common gastric-related conditions is gastroparesis. 

Endoscopic Botox Injections for Gastroparesis: Procedure Overview  

The treatment procedure for injecting Botox for refractory gastroparesis is conducted just like an upper endoscopy. It’s also sometimes called gastroscopy. During this procedure, the doctor inserts a long thin tube (gastroscope) into the mouth and it extends over the back of the throat, esophagus, and stomach until it reaches the small intestine. 

This gastroscope has a small built-in camera and it’s connected to a monitor to allow the doctor to examine the condition of your esophagus and stomach. Upon examination and identification of the potential injection points, they will deliver the botulinum toxin by inserting a tool at the tip of the gastroscope. 

The number of Botox units may vary per patient depending on the severity of their gastroparesis symptoms. Some studies suggest injecting around 80 to 100 units of Botox to see improvement in symptoms. 

On average, an endoscopic procedure can last for several minutes to an hour. The session may include additional tests such as gastric emptying examination, breath tests, or slow nutrient drinking test to get an accurate diagnosis of the causes and signs of your spastic disorders. 

Side Effects To Expect From Treating Gastroparesis With Botulinum Toxin 

Girl having a stomachache

After the treatment, the first thing you need to expect is that you may feel slightly lightheaded as the effects of sedation wear off. Most patients can also go home on the day of the procedure but it’s advised that you have a family member or friend who can drive you home. For the following days, you may experience some side effects as you recover from the treatment: 

More common side effects Less common side effects 
Abdominal pain and chest pain High fever   
Sore throat Allergic reaction 
Difficulty swallowing Scarring or ulceration 
Bleeding  

1) Abdominal and chest pain 

It’s quite common to experience abdominal pain and chest pain immediately after a gastroscopy procedure. As the thin tube passes down the esophagus to the digestive tract, it can be unavoidable for it to brush against the lining and cause some level of bruising which may result in pain in the abdomen. Chest pain and discomfort can also happen due to the test but they’ll eventually subside within a few days.  

2) Sore throat 

After the procedure, you may also have a mild sore throat or feel your voice becoming hoarse. This isn’t unusual and it’s a common reaction because of the gastroscope that was placed into the mouth. It can also be accompanied by some degree of dryness in the mouth. This side effect should resolve within a day or two and can be remedied by taking small sips of water. 

3) Difficulty swallowing 

You may also experience minor throat pain and discomfort which can make it difficult to swallow food and liquids for several days after treatment. In rare cases, the neurotoxin may also cause the injected muscle to contract instead of relaxing which can lead to temporary dysphagia where food has a hard time moving from mouth to the stomach. If this condition persists, it will require immediate medical treatment. 

4) Bleeding 

After the pyloric botulinum toxin injections, you may also experience coughing up small amounts of blood that come from the sputum. This probably happens due to the injections that are delivered to the muscles.  This should normally resolve within a few days. But if you begin vomiting excessive blood, you should see your healthcare provider for urgent treatment. 

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Wrinkles and fine lines are a thing of the past with a single Botox treatment. Book your first session of Botox today.

5) Feeling feverish 

Having a high-grade fever is usually a rare complication from an upper endoscopic procedure. If you observe a temperature of at least 38 degrees Celsius or higher, it may indicate that you developed an infection from the treatment. It’s advised that you contact your medical doctor for immediate treatment. 

6) Scarring or ulceration

While the treatment itself is non-surgical, there’s still a slight risk for scarring in the lower esophageal sphincter due to the tube and injections. Rarely, some small ulcers may develop in the esophagus as a result of a potential tear in the lining where the endoscopy tube passed through. Fortunately, these are temporary and can be remedied by taking some antibiotic medications. 

7) Allergic reaction

An allergic reaction is mostly related to the neurotoxin that was injected and not from the endoscopic procedure itself. While Botox is generally safe, some people may experience a delayed hypersensitivity response to botulinum toxin although it is very rare.

The common signs of a serious allergic reaction to Botox are itching, rashes, facial swelling, and trouble breathing. You should immediately notify your medical provider if you have an allergic reaction. 

What Is Gastroparesis And How Exactly Can Botulinum Toxin Therapy Help 

doctor holding virtual Stomach in hand

Gastroparesis is a chronic disorder that affects the normal movement of the muscles in the stomach. Usually, the contractions of the stomach muscles allow food to move through the digestive system. But in the majority of patients with symptoms of gastroparesis, their normal digestive functions are disrupted and they experience delayed gastric emptying as undigested food passes through the stomach more slowly. 

This stomach dysfunction can cause several uncomfortable symptoms such as: 

  • Vomiting food 
  • Loss of normal appetite 
  • Symptoms of nausea  
  • Abdominal bloating and chronic pain
  • Changes in blood glucose levels 
  • Weight loss and sometimes malnutrition 
  • Feeling of stomach fullness after eating several bites 

It’s hard to pinpoint the exact cause of refractory gastroparesis disorders but it’s mostly related to damage or injury to the vagus nerve which causes it to stop functioning normally. The vagus nerve is responsible for controlling the movement and emptying of food through the gastrointestinal tract. When this particular nerve gets impaired, food passes slowly or stops moving. Several reasons can cause damage to the vagus nerve like: 

  • Diabetes (leads to diabetic gastroparesis) 
  • Surgeries to the stomach, abdomen, esophagus, or small intestine
  • Viral infections or illnesses
  • Scleroderma 
  • Taking narcotic pain medications, antidepressants, and anticholinergics may also slow down gastric emptying time

And because gastroparesis is related to the muscles and nerves in the stomach, getting botulinum toxin injection can be a viable treatment alternative to provide symptomatic improvement. The neurotoxin injections are delivered endoscopically to the lower part of the esophagus or directly to the pyloric sphincter. It’s intended to disrupt the signals that cause the contractions of the muscles so that they’ll relax and allow food to be digested and pass smoothly to the small intestine. 

Botox can help individuals with gastroparesis in several ways: 

  • Improves swallowing and ingestion of food and liquids
  • Supports the muscles in the lower esophagus that control the opening to the stomach and promote normal gastric motility 
  • Improves stomach emptying to avoid discomfort and indigestion
  • Relaxes the smooth muscles in the stomach to increase gastric emptying rate
  • Relieves pyloric dysfunction to allow food to travel to the small intestine 

Botox Injection for Gastroparesis: Preparation and Aftercare Reminders 

young woman in turquoise shirt touching her tummy over grey background

To assure a safe experience throughout the endoscopic Botox injection procedure, there are several things you need to do to prepare for the treatment. Here are some of the important pre-procedure reminders: 

  • You will be asked to fast and go on a liquid-only diet for at least 24 hours prior to the procedure. 
  • For 4 to 6 hours before the treatment, you will be asked to stop drinking or consuming anything in the mouth. The stomach needs to be empty so that the doctor has a clear view of the whole treatment area during the gastroscopy. 
  • You will also be required to stop taking any medications for indigestion for at least 2 weeks before the treatment. 
  • You should also stop any blood-thinning drugs since they may increase the risk of bleeding during and after the procedure.
  • Make sure to inform your doctor if you are currently on medications for any chronic conditions such as diabetes or heart disease. They may need to alter your treatment according to your health condition. 
  • Make advance arrangements with your family or friends about who can accompany you to the treatment. You will not be allowed to drive on your own since you will still feel a bit drowsy from the sedation.

After the procedure, here are the aftercare instructions that you need to follow: 

  • Take it easy and rest for the remainder of the day after your treatment 
  • Avoid drinking alcohol and don’t take any sleeping medications 
  • For the first 24 hours after the procedure, you may still need to follow a soft diet and take lots of liquids 
  • You may take cough drops or gargle with warm salt water to help alleviate your sore throat 
  • You may resume eating regular foods within 48 hours or once your overall condition feels better 

How Does Botox Compare To Other Treatments for Gastroparesis  

As a therapeutic option for gastroparesis, the effects of Botox are usually temporary and you’d most likely need additional treatments for long-term relief. In clinical trials, the botulinum toxin injections have been shown to be effective for keeping its symptoms at bay for up to 3 months. 

But if you notice your symptoms are not improving with Botox or you simply want to explore other gastroparesis treatment options, here are the other available medical therapy solutions that you may try:  

TreatmentHow It Will Work 
Diet changesPatients with moderate symptoms of gastroparesis can mostly find relief from making changes to their diet. Changing your eating habits and making proper nutrition decisions can help control your digestion and promote healthy gastric emptying. If you have more severe symptoms, you’ll be required to go consume more soups and liquids. 
Medications There are several prescription medications that can help stimulate digestion in the stomach and provide relief of symptoms such as constipation, chronic nausea, and vomiting. Some of the common medications that may be recommended are prokinetic drugs like Metoclopramide and antibiotics like erythromycin. 
Feeding tube Gastroparetic patients who are unable to physically consume a soft or liquid diet may be required to undergo surgery to insert a feeding tube. This tube will directly send liquid food, nutrients, and medication to the small intestine and bloodstream. This is only necessary for patients with diabetic gastroparesis. 
Parenteral nutrition This treatment approach is similar to a feeding tube but the liquid food and medication is delivered via an intravenous (IV) line that is attached to the vein. Parenteral feeding treatment also intends to deliver nutrients directly to the bloodstream. 
Gastric electrical stimulation This is commonly used for patients with severe gastroparesis and those whose symptoms do not improve from dietary modification and medications. With gastric electrical stimulation, a device will be surgically implanted to provide electrical pulses to the nerves and smooth muscles in the stomach. Its primary goal is to reduce nausea and vomiting and stimulate the food to move to the digestive tract. 

Get Chronic Pain Relief At The Rejuvenation Center for Mind And Body 

Gastroparesis can be a debilitating and challenging disorder but thanks to recently available treatments such as Botox, you don’t have to worry anymore about suffering through stomach pain and discomfort. At the Rejuvenation Center for Mind and Body, our experienced doctors can provide you with a personalized treatment plan to help manage the symptoms of your chronic condition. 

Led by Dr. Eugene Festa, we at RCMB specialize in providing primary care treatments and expert medical advice to help you recover from pain and illnesses. We offer a wide range of services including nutrition counseling, internal medicine, diagnostic testing, and chiropractic care. For more information about our chronic disease treatments, contact us today at (973) 240 5695

Learn More: Dysport vs Botox: Which Wrinkle Injectable Has Less Side Effects?

A Smoother, Younger You Today

Wrinkles and fine lines are a thing of the past with a single Botox treatment. Book your first session of Botox today.

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