Extreme Esophageal Spasm Treated with Botulinum Toxin - Abstract
Diffuse esophageal spasm is a rare motility disorder. The primary symptoms
include dysphagia, and chest pain. There is array of treatments available from
medical therapy with nitrates to surgical therapy; Heller myotomy. We present a
case of severe Diffuse Esophageal Spasm (DES) that showed one of the highest Distal
Contractile Integral (DCI) per manometry. Patient was treated with Botulinum Toxin
(BTX) with complete resolution of symptoms. The use of botulinum toxin for treatment
of motility disorders; achalasia and diffuse esophageal spasm is well reported. We
present a case of a severe DES that responded well to endoscopic botulinum toxin
injections. This is a novel approach to DES who has failed conservative medical therapy.