Johns Hopkins Manual for GI Endoscopic Nurses, Third Edition

Mouen Khashab, MD; Toshunia Robinson, MD; Anthony Kalloo, MD

Chapter 48: Botulinum Toxin Injection In The Upper Gastrointestinal Tract: Antibiotic Prophylaxis For Gi Endoscopy (continued)

Rosa Maria Fusco, RN, BSN, CGRN; Stuart K. Amateau, MD, PhD

Botulinum toxin (Botox) is a potent neuromuscular blocker. It is used in the upper GI tract to relax smooth muscle. In the last decade its use has expanded to include smooth muscle disorders such as achalasia, diffuse esophageal spasm, dysphagia from nonspecific esophageal motility disorders, isolated hypertension of the LES, sphincter of Oddi dysfunction, oropharyngeal dysphagia, and gastroparesis. More recently, physicians have injected botulinum toxin into the muscle layer of the gastric antrum to inhibit peristalsis and achieve modest gastroparesis as a method of early satiety and weight…