Intrasphincteric botulinum toxin injection in the treatment of chagasic achalasia

Intrasphincteric botulinum toxin injection in the treatment of chagasic achalasia

Author Brant, C. Google Scholar
Moraes, JPP Google Scholar
Siqueira, E. Google Scholar
Nasi, A. Google Scholar
Libera, E. Google Scholar
Morais, M. Google Scholar
Rohr, M. Google Scholar
Macedo, E. P. Google Scholar
Alonso, G. Google Scholar
Ferrari, A. P. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
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.
Language English
Date 2003-01-01
Published in Diseases of the Esophagus. Carlton: Blackwell Publishing Asia, v. 16, n. 1, p. 33-38, 2003.
ISSN 1120-8694 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing Asia
Extent 33-38
Access rights Closed access
Type Article
Web of Science ID WOS:000180968000007

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