Gastrointestinal Uses of Botulinum Toxin

Cariati, Maria; Chiarello, Maria Michela; Cannistrà, Marco; Lerose, Maria Antonietta; Brisinda, Giuseppe

doi:10.1007/164_2019_326

Cited by 12 publications

(11 citation statements)

References 195 publications

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“…The botulinum toxin A (BTX) is a neurotoxin that induces blockage of neurons acetylcholine release at the neuromuscular junction, promoting muscle paralysis (36). BTX has been used in the lower esophageal sphincter, promoting the reduction of sphincter contraction, and facilitating esophageal food transit.…”

Section: Botulinum Toxin Injectionmentioning

confidence: 99%

Evaluating the Non-conventional Achalasia Treatment Modalities

Tustumi

2022

Front. Med.

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IntroductionAchalasia is a primary esophageal dysmotility disorder. Despite the high volume of studies addressing the conventional treatments for achalasia, few are debated regarding the non-conventional treatments, such as cardiectomy, cardioplasty, endoluminal substances injection (ethanolamine oleate, polidocanol, botulinum toxin), stents, and certain drugs (beta-agonists, anticholinergic, nitrates, calcium channel blockers, and phosphodiesterase inhibitors).MethodsA critical review was performed.ResultsEndoscopic, surgical, and pharmacological treatments were included. A qualitative synthesis was presented.ConclusionNon-conventional therapeutic options for treating achalasia encompass medical, endoscopic, and surgical procedures. Clinicians and patients need to know all the tools for the management of achalasia. However, several currently available studies of non-conventional treatments lack high-quality evidence, and future randomized trials are still needed.

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Section: Botulinum Toxin Injectionmentioning

confidence: 99%

Evaluating the Non-conventional Achalasia Treatment Modalities

Tustumi

2022

Front. Med.

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“…Botulinum toxin may be also used in the esophagus and stomach for achalasia, hypertensive LES, or gastroparesis. [59][60][61][62] With the advent of narrow-caliber transnasal channeled endoscopes, these injections can be undertaken unsedated in the office setting in selected patients. 62 Esophageal dilation has been performed since the 17th century, originally using whalebone.…”

Section: Therapymentioning

confidence: 99%

“…Therefore, small volumes of high concentration with injection into the posterior midline CP muscle is the preferred approach. Botulinum toxin may be also used in the esophagus and stomach for achalasia, hypertensive LES, or gastroparesis 59–62 . With the advent of narrow‐caliber transnasal channeled endoscopes, these injections can be undertaken unsedated in the office setting in selected patients 62 …”

Section: Managementmentioning

confidence: 99%

Aspects of the assessment and management of pharyngoesophageal dysphagia

Allen

Dewan

Herbert

et al. 2020

Annals of the New York Academy of Sciences

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Swallowing complaints are common and may have significant consequences for nutrition and pulmonary health. Etiology varies and different aspects of the deglutitive system may be affected. A thorough assessment from the oral cavity to the stomach will provide physiologic information that enables specific targeted management plans to be devised. Although the swallow trajectory bridges anatomic areas, there has previously been a tendency to compartmentalize assessment and treatment by arbitrary anatomic boundaries. It is now clear that this approach fails to appreciate the complexity of swallow mechanics and that systems (oral, pharyngeal, esophageal, and pulmonary) are intertwined and codependent. Swallowing specialists from different backgrounds and with complementary skill sets form a multidisciplinary team that can provide insight and address multiple areas of management. With the advent of new tools for instrumental evaluation, such as manometry, targeted rehabilitative strategies can be informed by physiology, increased in precision and breadth, and assessed quantitatively. Surgical approaches have evolved toward endoscopic techniques, and food technology is expanding options in dietary management. The multidisciplinary team is core to managing this varied and often neglected patient population. This review is for clinicians treating swallowing disorders and will explore the selected aspects of the assessment and management of pharyngoesophageal swallowing disorders.

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“…Инъекция ботулинического токсина в дуоденальный сосок ведет к обратимому торможению выделения ацетилхолина в локальных двигательных нейронах, в результате чего реализуется антиспазматическое действие [23,24].…”

Section: лечениеunclassified

Sphincter of Oddi dysfunction in the post-cholecystectomy period

Буеверов

2020

Medicinskij sovet

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The persistent post-cholecystectomy (CE) symptoms can be divided into four groups: 1) surgical errors; 2) recurrence of cholelithiasis; 3) functional disorders due to removal of the gallbladder (transient or persistent); 4) pathology not associated with CE. Biliary pain persists in 20–40% of patients after CE, in most cases caused by sphincter of Oddi dysfunction (SOD). SOD is subdivided into biliary, pancreatic, two-duct types, as well as pancreatobiliary reflux. The SOD is rooted in the increased pressure in the sphincter, which leads to the increased intraductal pressure and, as a result, to the occurrence of biliary or pancreatic pain. In addition, the direct contractile effects of cholecystokinin on smooth muscles of the biliary tract change due to mechanical disturbance of innervation. Hypertension of the pancreatic part of the sphincter of Oddi can cause not only the occurrence of functional pain of the pancreatic type, but also the development of recurrent pancreatitis. SOD is characterized by typical anamnestic data that are common to the functional pathology of the digestive system, such as duration of symptoms, absence of organic pathology, multiple complaints, a non-progressive course, the provoking role of psychoemotional factors. From a practical standpoint, the clinical criteria for SOD can be: 1) an attack of biliary or pancreatic pain; 2) a transient increase in the activity of hepatic or pancreatic enzymes; 3) transient expansion of the common bile or major pancreatic duct. If it is difficult to differentiate diagnosis, endoscopic ultrasonography is advisable. Antispasmodics and ursodeoxycholic acid form the basis of the treatment, especially when biliary sludge and microlithiasis are detected. There must be strong arguments for the surgical treatment.

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Gastrointestinal Uses of Botulinum Toxin

Cited by 12 publications

References 195 publications

Evaluating the Non-conventional Achalasia Treatment Modalities

Evaluating the Non-conventional Achalasia Treatment Modalities

Aspects of the assessment and management of pharyngoesophageal dysphagia

Sphincter of Oddi dysfunction in the post-cholecystectomy period

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