Botulinum toxin A for the treatment of achalasia.
Pneumatic balloon dilatation of the esophagus is one of the current recommended treatment for achalasia. This procedure is associated with risks such as esophageal rupture. Surgery and percutaneous gastrostomy tube placement has been performed in severely affected individuals. The Botulinum Toxin A (BoTxA) is widely used to treat neuromuscular conditions in which spasticity is of concern. We present four cases in which BoTxA was used as an alternative of treatment and in which less invasive modalities were unsuccessful. The patients received a total of 80 units of BoTxA, applied to the submucosa in doses of 20 units in each predetermined quadrants to the lower esophageal sphincter. All patients demonstrated improvement of their symptoms without side effects in this study.
Rodríguez Cruz
E
E
Dept. of Combined Internal Medicine and Pediatrics, Saint Joseph Mercy Oaldand, Pontiac, Michigan 48341, USA. ERODRI@mem.po.com
Sheehan
C
C
Fraiberg
E
E
Hasan
S
S
D000368:Aged; D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D004931:Esophageal Achalasia / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins