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Published on: November 9, 2016
Botulinum toxin for achalasia in children
K S Ip1, D J Cameron, A G Catto-Smith
1Department of Paediatric Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne, Victoria, Australia.
Journal of Gastroenterology and Hepatology
|December 6, 2000
Summary
Botulinum toxin injections effectively relieve achalasia symptoms in children. While symptom relief is common, sustained responses beyond six months occurred in 43% of pediatric patients, necessitating retreatment.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Pharmacology
Background:
- Achalasia is a rare esophageal motility disorder.
- Botulinum toxin (BTx) injections into the lower esophageal sphincter (LES) are an established treatment for adult achalasia.
- The efficacy of BTx in pediatric achalasia patients requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of botulinum toxin (BTx) injections in treating pediatric patients diagnosed with achalasia.
- To assess the duration of symptom relief and identify factors influencing treatment response in children.
Main Methods:
- A cohort of seven pediatric achalasia patients received intrasphincteric BTx injections.
- Patients had varying prior treatment histories.
- Follow-up duration was a median of 15 months.
Main Results:
- All seven pediatric patients experienced symptom improvement following BTx injection.
- The median duration of symptom relief before recurrence was 4 months (range: 1-14 months).
- A significant inverse relationship was observed between pretreatment LES pressure and response duration (r=-0.6), with lower pressures correlating to longer relief.
Conclusions:
- Botulinum toxin injections provide effective short-term symptom relief for pediatric achalasia.
- Sustained symptom relief beyond six months was achieved in 43% of the pediatric patients.
- All patients required repeat treatment, highlighting the need for ongoing management strategies.
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