Tu2025 DOES RESPONSE TO BOTULINUM TOXIN INJECTION PREDICT FUTURE RESPONSE TO PERORAL PYLORIC MYOTOMY (POP) IN PATIENTS WITH REFRACTORY GASTROPARESIS?

Gastroparesis is a chronic gastrointestinal condition that is difficult to treat with limited treatment options. Two treatment modalities that may be helpful include botulinum toxin (BT) injection of the pyloric sphincter and endoscopic balloon dilatation. Recently, there has been advent of a new technique called peroral endoscopic myotomy (POP) where the pyloric muscle is cut by creating a submucosal tunnel. Given its relatively safe and less invasive nature, BT injection is often attempted before more invasive treatments such as POP. To our knowledge, there are no studies investigating if a response to BT can predict a response to POP. Our hypothesis is that a clinical response to BT injection of the pyloric sphincter is not necessary to indicate a future clinical response to POP.