Botulinum toxin in the treatment of diffuse esophageal spasm

被引:19
作者
Bashashati, M. [1 ]
Andrews, C. [1 ]
Ghosh, S. [1 ]
Storr, M. [1 ]
机构
[1] Univ Calgary, Div Gastroenterol, Dept Med, Calgary, AB T2N 4N1, Canada
关键词
botulinum toxin; diffuse esophageal spasm; esophagus; motility disorder; NONCARDIAC CHEST-PAIN; PRIMARY MOTILITY DISORDERS; HIGH-RESOLUTION MANOMETRY; MOTOR DISORDERS; SURGICAL-TREATMENT; EXTENDED MYOTOMY; ACHALASIA; INJECTION; ABNORMALITIES; NIFEDIPINE;
D O I
10.1111/j.1442-2050.2010.01065.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
P>Diffuse esophageal spasm is a primary esophageal motility disorder. The prevalence is 3-10% in patients with dysphagia and treatment options are limited. This review summarizes the treatment of diffuse esophageal spasm, including pharmacotherapy, endoscopic treatment, and surgical treatment with a special focus on botulinum toxin injection. A PubMed search was performed to identify the literature using the search items diffuse esophageal spasm and treatment. Pharmacotherapy with smooth muscle relaxants, proton pump inhibitors, and antidepressants was suggested from small case series and uncontrolled clinical trials. Endoscopic injection of botulinum toxin is a well-studied treatment option and results in good symptomatic benefit in patients with diffuse esophageal spasm. Surgical treatment was reported in patients with very severe symptoms refractory to pharmacologic treatment. This article summarizes the present knowledge on the treatment of diffuse esophageal spasm with a special emphasis on botulinum toxin injection. Endoscopic injection of botulinum toxin is presently the best studied treatment option but many questions remain unanswered.
引用
收藏
页码:554 / 560
页数:7
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