Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Ethanolamine Oleate Versus Botulinum Toxin in the Treatment of Idiopathic Achalasia



Mikaeli J1 ; Veisari AK1 ; Fazlollahi N1 ; Mehrabi N1 ; Soleimani HA1 ; Shirani S2 ; Malekzadeh R1
Authors
Show Affiliations
Authors Affiliations
  1. 1. Departments of aGastroenterology, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Departments of Radiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Annals of Gastroenterology Published:2015

Abstract

Background Botulinum toxin (BT) injection reduces lower esophageal sphincter pressure and alleviates symptoms in idiopathic achalasia (IA). Ethanolamine oleate (EO) has also been introduced for the treatment of IA. We compared the long-term efficacy of BT and EO injections in the treatment of IA. Methods A total of 189 IA patients were evaluated prospectively, of whom 21 were unwilling to undergo or were poor candidates for pneumatic balloon dilation and Heller myotomy and were enrolled in the study. Eleven patients were treated by BT, and 10 by EO injections. Patients were followed up by achalasia symptom score (ASS), timed barium esophagogram (TBE), and high-resolution manometry at baseline and post-treatment. A good initial response was defined as a decrease in ASS to 4 or less, and a reduction in barium column height and volume in TBE by >50%. Results All 10 EO group patients and 10 of 11 BT group patients showed a good initial response. Four EO group relapsers and 6 BT group relapsers were managed effectively by re-injections. Mean duration of follow up was 27.38 months. On completion of the study, a sustained good response was seen in 9 and 6 patients in EO and BT groups, respectively (P=0.149). Conclusion This study revealed that BT and EO have comparable efficacy in the treatment of IA. However, the cost of EO is about 2 times lower than BT. © 2015 Hellenic Society of Gastroenterology.