Treatment with botulinum toxin of octo-nonagerians with oesophageal achalasia: a two-year follow-up study.
BACKGROUND
Treatment of oesophageal achalasia with intrasphincteric injections of botulinum toxin has proved to be a successful alternative treatment modality. However, little is known about its long-term effects in very old patients.


OBJECTIVE
To evaluate the effects of such treatment in octo-nonagerians during a 2-year follow-up period.


METHODS
Thirty-three patients with idiopathic oesophageal achalasia (range 81-94 years) entered the study. After basal evaluation and screening procedures, 100 U of botulinum toxin was injected at the lower oesophageal sphincter, and the procedure was repeated 1 month later. Data were collected at baseline and were compared after 1 and 2 years following the procedure.


RESULTS
Seventy-eight per cent of patients were considered responders at 1 year and 54% were considered responders at 2 years. The weight gain at the end of the follow-up period was 2 (0-3) kg. No significant relationship was found between baseline lower oesophageal sphincter pressure and symptoms score after 1 and 2 years of follow-up; moreover, no major complications of botulinum toxin therapy were reported.


CONCLUSIONS
Treatment of very old achalasic patients with botulinum toxin is safe, effective and yields good quality of life in a substantial proportion of these subjects.
Bassotti
G
G
Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy. gabassot@tin.it
D'Onofrio
V
V
Battaglia
E
E
Fiorella
S
S
Dughera
L
L
Iaquinto
G
G
Mazzocchi
A
A
Morelli
A
A
Annese
V
V
D000367:Age Factors; D000369:Aged, 80 and over; D001905:Botulinum Toxins / Q000627:therapeutic use*; D004931:Esophageal Achalasia / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D016896:Treatment Outcome
D001905:Botulinum Toxins