A. Rollan et al., ENDOSCOPIC INTRASPHINCTERIC INJECTION OF BOTULINUM TOXIN FOR THE TREATMENT OF ACHALASIA, Journal of clinical gastroenterology, 20(3), 1995, pp. 189-191
Three patients with achalasia were treated with endoscopic injection o
f botulinum toxin (BoTx). BoTx (80 U) was injected via a sclerotherapy
needle into the lower esophageal sphincter (LES). One patient complai
ned of transient heartburn that resolved after omeprazole treatment. T
wo patients reported sustained symptomatic improvement. They were able
to eat normally 48 h after treatment and have remained symptom free f
or 5 and 6.5 months, respectively. In these patients, esophageal manom
etry 4 months after treatment showed a marked reduction of resting LES
pressure and the appearance of a previously absent LES relaxation aft
er swallowing. The third patient had only a transient clinical improve
ment, with occasional dysphagia beginning 3 months after treatment. Al
l patients showed unchanged aperistalsis of the esophageal body. Its l
ess invasive nature compared with other therapeutic alternatives may g
ive BoTX injection a role in the treatment of some patients with achal
asia.