Botox Injections and Achalasia

Has anyone tried Botox injections as a form of treatment? Did it work? If so, how long?
Some sites warn against it because you can get a lot of scar tissue over time. When this happens, the only treatment would be the Heller Myotomy “open method”. I wonder if it’s worth it…

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Don’t think you received my first message. I have had 5 boxtox injections and still h ave esophageal spasms. Take nitro & zanax for them. This is 2 wks. past and still on Ensure. Even feel sorry for the dr. since he doesn’t know what else to do.

Have you heard any more suggestions from your doctor?

Vinnie here had 2 botox injections,first one lasted 6mos,second one lasted 2wks, the doc said no more because of scarring in the LES,had a pneumatic balloon dilation in Dec,07 worked so far till last week, now i have to belch after each swallow,dont know if this a bad sign of it returning-Cheerio

Did the doc explain why it lasted only 2 weeks? I thought the injections were supposed to help for at least 6 months?? Also, you developed scar tissue after only two times? Wow. That is pretty scary. Were you able to belch before the dilation? For me, I cannot belch/burp at all. Only occasional hiccups. So what are your plans now? Have you considered surgery??

Hi Tatiana,Vinnie here sorry to hear what your going through,my symptoms were food getting stuck in the throat area then 20 seconds food would go down, followed by hiccups,regurgitation was mostly mucous in the mouth and nose,as for heartburn,mine’s was felt between my shoulder blades, went to the University of Penn Hospital in Phila for a manometry test had absent peristalsis in the distal esophagus,doc did a Botox injection, felt great eating a big mac and coke, but it only lasted 6mos, 2nd one lasted 2 weeks, he said no more injections due to risk of scarring, its either balloon dilation or myotomy, did a barium swallow had narrowing in the cardia junction,{birdsbeak}. I chose dilation because it was simpler and less invasive, was told i would have to take heartburn medicine for the rest of my life,which was baloney, haven’t had heartburn since the dilation,when the endoscopy dilation procedure was done, no scarring was seen,anyway my symptoms are not quite severe yet, but if it returns i’ll go for a 2nd dilation, then who knows what after that-Peace Vinnie

Hi - I must not have communicated correctly. This is the 5th botox, the 4th lasted about 2 wks, but previously I got 7 mos. out of the the others. Now I am 2wks. past the 5th and still have terrible spasms if I have anything other than liquids or semi-liquids.

The dr. has put me on nifedipine and I still use the nitro. He does not know of anything else to do since I do not have achalasia, only diffuse esoph. spasm, which is painful and comes in spasms along the esoph. He tells me to hang in since it may take longer for the botox to work. The procardia (nifedipine) really drops my b.p. to about 80/60. So I am hanging!

Hope you are better, write soon.

You may already know this, Botox is a protein and so can become targeted by your immune system. In some people that never happens. In others it can happen on the fist use or after any number of uses. Once it does Botox injections will not last as long if they even work at all. With DES you don’t have a lot of options, so I hope he can keep your Botox working.


What is the difference between DES and Achalasia?

Vigorous Achalasia patients have spasms too (like me). Is it that Achalasia is characterized by the "bird’s beak" at the end of the esophagus?

I heard DES could develop into Achalasia. Have you discussed having surgery with your doc? It seems like the botox is losing its effect and I would be scared about scar tissue.

How is the procardia (nifedipine) working?

Also you mentioned you are on a liquid/semi-liquid diet just like me. What kind of things are you drinking? I need something to bring my energy up at work but I have to avoid caffeine.

Sorry I am asking so many questions – I am really new to this so I want to learn as much as I can about it.

Hang in there, I hope you feel better soon as well :slight_smile:

Thanks for your reply - always happy to hear from a fellow traveler. The difference is that I have no difficulty swallowing, but the LES spasms, therefore giving me these horrible angina-like pain along the chest wall. It can develop into achalasia, but had the last botox treatment 2 wks. ago with dilation and the dr. said I did not have this. He was not worried about scarring and I do trust him. He has been my gastro. for over 20 years and so has this problem.

As for liquid diets, I use Ensure, Boost and even Slim-fast. It is the cheapest and still have vitamins and minerals. I have a blender and fix shakes with Soy milk, banana, yogurt and blueberries. Absolutely delicious! The only problem is I can’t drink it very cold, so have to wait until it is almost room temp. You can also use Tofu if you are into this stuff. Otherwise, flavored yogurt, banana, milk, protien powder, etc, etc. One can get very creative if necessary!

Hanging in along with you.
Thanks again.

Thanks for the drink tips! I actually went out and bought Slim Fast last night and I am drinking it now :slight_smile: It’s not too bad… I will try the fruit smoothies you suggested this week… I am just sick of eating watery soup and ice cream. I think the more variety I have the better I can get through this. Hope everything is fine with you and please keep in touch.

Good to hear from you. Try the Slim Fast Cappuchino - it is my favorite. I am in the same situation as you, I am so tired of liquids, but my esoph. knows when I put down even a creamed soup! Isn’t that strange?
Still have the pain in the chest, but take the nitro and that seems to tame it down a bit. Tomorrow will be 3wks. past the botox inj. & dilation, so am hanging in.

Take good care of yourself and also keep in touch.

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