************ The G-PACT Knowledge Base ************

Botox and GP - (Botulinum Toxin)

Botox, or (Botulinum Toxin), is a relatively new treatment for
esophageal disorders. It is used principally to treat achalasia, a
swallowing disorder in which the lower sphincter muscle of the
esophagus fails to open (relax/weaken) appropriately, preventing
food from passing effectively into the stomach. This has proven to
be very useful in some people who suffer from abnormal muscle
contractions.

A newer endoscopic treatment is the injection of the botulinum toxin
into the lower sphincter, called the pyloric valve, to weaken the
muscle. The pyloric valve is the outlet from your stomach into the
small intestine where food is suppose to empty. In a procedure, they
call pyloroplasty, they cut the pyloric valve in order to create a
larger opening from your stomach to the small intestines. This is to
help with the stomach emptying process and is done laproscopically.
The injections are often guided by an electromyogram (EMG) with the
hollow needle (EMG) is used to locate the area of the worst
contraction within the muscle, therefore allowing the Botox to be
injected at that site and is then able to provide the best results.
It is with this procedure they are hoping to help Gastroparesis
patients so that food does not remain in the stomach for an
unusually long period of time.

As preliminary studies have shown the use of botulinum toxin is
safe, but the effect on the esophagus or the lower pyloric valve may
be temporary, and additional botulinum toxin therapy may be
necessary. Since botulinum toxin therapy is relatively new, it's not
known how well such therapy will work over a period of many years.  

************ Spotlight Patient  ************

"Lea Cook"
www.g-pact.org

My name is Lea and I was diagnosed with Gastroparesis, not through
my stomach, but through my lungs. Let me explain. For years I had
some mild stomach problems, but in 1995, after the birth of my son
Joshua, I began having multiple respiratory infections and
aspiration pneumonia. No one could figure out why I was so sick all
the time. I was accused by one doctor of making myself sick and in
the need of serious mental health treatment (which was funny, since
I am also a psychiatric nurse). 

I finally found a pulmonologist in 2000 who suggested that I might
be having esophageal reflux causing my lung infections and sent me
to a GI specialist. My GI suggested I have the Nissan fundiplication
for the reflux (they wrap your esophagus around your stomach to
strengthen the valve that lets food stay in your stomach, technical,
huh?). They did a gastric emptying scan (GES) as part of their preop
testing. No problem. The test would only take 30 minutes. The 30
minutes turned into 3 hours, where they continued to scan and then
rescan my stomach. The technician said it was one of the
most "impressive" tests she had seen, and it "wasn't good." Not only
did I have severe Gastroesophageal reflux disease, but I also had
severe idiopathic Gastroparesis.  

That was 2 years ago, and I have had almost a complete remission of
my gastroparesis.

I credit God and Carissa Haston with giving me the HOPE needed to
beat this disease and live a normal life again. Without my faith and
the support I received from the internet group, I don't know how I
would have survived this ordeal. My prayer is that a cure and
effective treatments will be discovered for this disease, soon.

To read the complete story about Lea, please go to www.g-pact.org
where you will find her in the "Spotlight Patient" section of the G-
PACT website. This page also includes a place for people to nominate
a spotlight patient as well as read about our previous spotlight
patients and their stories.

                                                           
************ Welcome ***********

G-PACT would like to welcome our new board member, Nicole Whitis. 
Nicole will serve as Publications Director. She is an excellent addition with experience in computers/web/editing.  As Publications Director, she will
be helping with the website and monthly newsletters.

Carissa is also looking for additional assistance in order to maintain and
add to the website, so please write to webmaster@g-pact.org if you have an interest in this or further questions about the responsibility.