PMID- 11820389
OWN - NLM
STAT- MEDLINE
DCOM- 20020418
LR  - 20191105
IS  - 0179-051X (Print)
IS  - 0179-051X (Linking)
VI  - 17
IP  - 1
DP  - 2002 Winter
TI  - Case report: botulinum toxin in hypertensive lower esophageal sphincter: a 
      manometric case study.
PG  - 75-80
AB  - The hypertensive lower esophageal sphincter (HLES) is a disorder of esophageal 
      motility associated with dysphagia and chest pain. Although well characterized 
      manometrically, opinions differ greatly with regard to its pathophysiology and 
      its management. Therapy is limited to a few medications, esophageal dilatation, 
      and even surgery, although none of these options are consistently successful. In 
      this case report we describe a 54-year-old woman with HLES and dysphagia who was 
      successfully treated with botulinum toxin injection of the lower esophageal 
      sphincter (LES). Esophageal manometry after botulinum toxin therapy revealed 
      normalization of LES pressures. Three months after therapy, symptoms returned and 
      repeat esophageal manometry demonstrated the return of elevated LES pressures. 
      This report is the only published case of botulinum toxin injection into the LES 
      with both pre- and post-treatment esophageal manometric data. This case report is 
      evidence that LES dysfunction produces symptoms in patients with HLES, and that 
      reduction in LES pressure improves symptoms. Current pathophysiologic hypotheses 
      for HLES-associated dysphagia and its treatment are briefly reviewed in this 
      report.
FAU - Lacy, Brian E
AU  - Lacy BE
AD  - The Marvin M. Schuster Center for Gastrointestinal Motility and Digestive 
      Disorders, Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224, USA.
FAU - Zayat, Estephan N
AU  - Zayat EN
FAU - Crowell, Michael D
AU  - Crowell MD
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Dysphagia
JT  - Dysphagia
JID - 8610856
RN  - 0 (Anti-Dyskinesia Agents)
RN  - EC 3.4.24.69 (Botulinum Toxins)
SB  - IM
MH  - Anti-Dyskinesia Agents/*therapeutic use
MH  - Botulinum Toxins/*therapeutic use
MH  - Deglutition Disorders/*drug therapy/*physiopathology
MH  - Female
MH  - Humans
MH  - Manometry/methods
MH  - Middle Aged
EDAT- 2002/02/01 10:00
MHDA- 2002/04/19 10:01
CRDT- 2002/02/01 10:00
PHST- 2002/02/01 10:00 [pubmed]
PHST- 2002/04/19 10:01 [medline]
PHST- 2002/02/01 10:00 [entrez]
AID - 10.1007/s00455-001-0104-6 [doi]
PST - ppublish
SO  - Dysphagia. 2002 Winter;17(1):75-80. doi: 10.1007/s00455-001-0104-6.