Botulinum toxin for achalasia in children

Background: Injection of botulinum toxin (BTx) into the lower esophageal sp hincter (LES) of adult patients with achalasia results in the effective rel ief of symptoms. The aim of the present study was to examine the effectiven ess of BTx in pediatric patients suffering from achalasia. Methods: Seven patients suffering from achalasia with or without prior trea tment were treated with intrasphincteric injection of BTx. The median durat ion of follow up was 15 months. Results: All seven patients improved. The median interval before recurrence of symptoms was 4 months (range 1-14 months). There was an inverse relatio nship between the pretreatment LES pressure and the duration of response (r = -0.6). The mean pretreatment LES pressure in the subgroup with a respons e greater than 6 months was 38 +/- 10 mmHg compared with 61 +/- 12 mmHg in the other four patients (P = 0.05). All seven patients required retreatment . Conclusion: Botulinum toxin is effective in relieving symptoms in pediatric patients suffering from achalasia, producing a sustained response beyond 6 months in 43% of patients. (C) 2000 Blackwell Science Asia Pty Ltd.