title: Safety and efficacy of botulinum toxin injection therapy for esophageal achalasia in Japan.
abstract: Botulinum toxin injection is an accepted treatment modality for esophageal achalasia in western countries. This pilot study aimed to clarify the effectiveness of botulinum toxin injection for esophageal achalasia in Japanese patients. We enrolled 10 patients diagnosed with esophageal achalasia between 2008 and 2014. A total of 100 U botulinum toxin A was divided into eight aliquots and injected around the esophagogastric junction. We compared the lower esophageal sphincter pressure before and 1 week after treatment. Scores of subjective symptoms for esophageal achalasia were assessed using a visual analog scale (VAS) before and after 1 week of follow-up of treatment. Barium passage was improved in barium esophagography and passage of contrast agent was also improved. Mean Eckardt score was reduced from 5.5 to 1.6 after treatment (p<0.001). By esophageal manometric study, mean lower esophageal sphincter pressure was reduced from 46.9 to 29.1 mmHg after treatment (p = 0.002). One week after treatment, mean VAS score was reduced from 10 to 3.9 (p<0.001). There were no side effects in any cases. Botulinum toxin injection for esophageal achalasia was safe and effective with few complications. Therefore, botulinum toxin could be used as minimally invasive therapy for esophageal achalasia in Japan.
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamaguchi
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan.
authors.forename: Nanae
authors.initials: N
authors.lastname: Tsuruoka
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1 Nabeshima, Saga City, Saga 849-8501, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
keywords: botulinum toxins; endoscopy; esophageal achalasia; esophageal sphincter; injections