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Intrasphincteric botulinum toxin injection in the treatment of chagasic achalasia.
- Source :
-
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus [Dis Esophagus] 2003; Vol. 16 (1), pp. 33-8. - Publication Year :
- 2003
-
Abstract
- According to the WHO, 16-18 million people in Central and South America are infected by Trypanosoma cruzi. Chagasic achalasia affects between 7.1% and 10.6% of the population. The aim of this study was to evaluate the effects of Botox injections in the clinical response and esophageal function of patients with dysphagia due to chagasic achalasia. In total, 24 symptomatic patients with chagasic achalasia were randomly chosen to receive Botulinum Toxin (BT) or saline injected by endoscopy in the lower esophageal sphincter (LES). Patients were monitored with a clinical score of dysphagia and an objective assessment (esophagograms, scintillography, manometry, and nutritional assessment) for a period of 6 months. Clinical improvement of dysphagia was statistically significant (P < 0.001) in patients receiving BT when compared with the placebo. There was no significant difference in the placebo group regarding clinical score, LES basal pressure and esophageal emptying time. Esophageal emptying time in the toxin group was significantly lower than in the placebo (P=0.04) after 90 days. There were non-significant increases in esophageal emptying of 25.36% and 17.39%, respectively, at 90 and 180 days, in the BT group (P=0.266). Gender, age, and baseline LES pressure did not influence the response to BT. Our data strongly suggests that intrasphincteric injection of BT in LES is clinically effective in the treatment of chagasic achalasia.
- Subjects :
- Adolescent
Adult
Aged
Double-Blind Method
Drug Administration Schedule
Esophageal Achalasia diagnosis
Esophagogastric Junction drug effects
Esophagoscopy
Female
Follow-Up Studies
Humans
Injections, Intralesional
Male
Middle Aged
Probability
Prospective Studies
Recovery of Function
Reference Values
Severity of Illness Index
Treatment Outcome
Anti-Dyskinesia Agents administration & dosage
Botulinum Toxins administration & dosage
Chagas Disease complications
Esophageal Achalasia drug therapy
Esophageal Achalasia etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1120-8694
- Volume :
- 16
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
- Publication Type :
- Academic Journal
- Accession number :
- 12581252
- Full Text :
- https://doi.org/10.1046/j.1442-2050.2003.00287.x