title: Treatment with botulinum toxin of octo-nonagerians with oesophageal achalasia: a two-year follow-up study.
abstract: 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.
authors.affiliation: Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy. gabassot@tin.it
authors.forename: G
authors.initials: G
authors.lastname: Bassotti
authors.forename: V
authors.initials: V
authors.lastname: D'Onofrio
authors.forename: E
authors.initials: E
authors.lastname: Battaglia
authors.forename: S
authors.initials: S
authors.lastname: Fiorella
authors.forename: L
authors.initials: L
authors.lastname: Dughera
authors.forename: G
authors.initials: G
authors.lastname: Iaquinto
authors.forename: A
authors.initials: A
authors.lastname: Mazzocchi
authors.forename: A
authors.initials: A
authors.lastname: Morelli
authors.forename: V
authors.initials: V
authors.lastname: Annese
mesh_terms: 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
chemical_list: D001905:Botulinum Toxins