As a consequence, food does not pass through the esophagus to the stomach in a normal way. Achalasia causes difficulty swallowing, chest pain, frequent regurgitation, and bad breath. Achalasia has been treated by inflating a plastic balloon spanning the lower esophageal sphincter to break the sphincter muscles, a procedure known as pneumatic dilation. When pneumatic dilation was unsuccessful, surgery was necessary to cut through the lower esophageal sphincter, in a procedure called a myotomy. Botulinum toxin has been used with greater safety and with effectiveness equal or superior to the older methods to treat achalasia.
Botulinum toxin is injected through an endoscope, as the gastroenterologist views the sphincter.
Its effects on the sphincter last for months to years, and it is possible to repeat the injection of botulinum toxin when symptoms recur. All rights reserved.