The team investigated whether botulinum toxin (BTX) injection can treat symptomatic diffuse esophageal spasm
The findings of the study were published in the December issue of Gastrointestinal Endoscopy.
Nine symptomatic patients (6 women, 3 men; 57-86 years) with manometrically proven diffuse esophageal spasm underwent BTX injection.
One hundred IU BTX were diluted in l0 ml of saline solution. This was injected endoscopically at multiple sites along the esophageal wall, beginning in the region of the lower esophageal sphincter and moving proximally in 1- to 1.5-cm intervals, and into endoscopically visible contraction rings.
Symptom scores, based on an analogue scale for dysphagia, regurgitation, and non-cardiac chest pain, were assessed before and after therapy, 1 day thereafter, and at 1 and 6 months.
The researchers found that symptoms improved immediately in 7 (78%) patients after 1 injection session.
| Symptoms improved in 78% of patients after just 1 injection session.
| Gastrointestinal Endoscopy |
After 4 weeks, 8 (89%) patients were in remission with a decrease in total symptom score.
The total symptom score decreased from a median of 8.0 before treatment, to 2.0 after 1 day and to 2.0 after 1 month.
After 6 months all 8 patients with a response at 1 month still had a symptom score of 3 or less without further treatment.
Subsequently, 4 patients required reinjection 8, 12, 15, or 24 months after the initial treatment with similarly good results.
The team observed no serious adverse effects.
Dr Martin Storr, of the Technical University of Munich, said on behalf of his colleagues, "BTX injection at several levels of the tubular esophagus is an effective treatment for patients with symptoms caused by diffuse esophageal spasm."
"Symptom relapse can be effectively treated by repeated BTX injection," he concluded.