Digestive Disorders / Gastroenterology Expert Forum
Botox injection for stomach
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Botox injection for stomach

Confirmed Gastroparesis, as well as Chronic Pancreatitis and IBS.  I have had my gallbladder removed and had to have a Sphincter of Oddi surgery with pancreatobiliary sphincterotomy.  Upper abdominal pain/pressure  is present almost every day and can't find the right med to help.   In addition, currently I have been only able to eat soft foods such as baked pot., rice, pudding, etc.  Now, anytime I eat even the smallest amounts I immediately have an acidic taste in my mouth.
Last doctor I went to did not think gastroparesis was the problem, but rather functional dyspepsia. He tried me on Neurontin for pain, Viokase 16 enzymes and occasionally Bentyl.  Also, Darvocet N 100 as needed.  Current doctor does believe Gastroparesis is the right diagnosis, as well as SIBO.  Also, he believes the pain may be neuropathic. He tried me on Reglan again, but cannot take due to side effects.  I am currently on Cipro 250/2x daily for 15 days. For pain he may try me on Lyrica.  For the acidic taste in mouth he said to take the Nexium twice daily, but if it is bile problem he might try me on questran?  Also, he is thinking about trying a botox injection in the stomach to help with emptying.  
Do you think this is all stomach related, or do you think it could be small bowel obstruction? What are your thoughts on the Botox?  How do I know if the pain is neuropathic?
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I can't say for sure without examination.

If SBO is a concern, an imaging study like a CT scan can exclude that condition.

Botox injections for gastroparesis is in the investigational stage.  If you can find an academic medical center that can try this, it is worth considering if all the other options have been exhausted.

The other option is a gastric pacemaker, another therapy that is reserved for refractory cases.  

As for whether the pain is neuropathic, you can consider a referral to a neurologist.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com
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