Botulinum toxin in the treatment of achalasia

Botulinum toxin type A is used in the treatment of achalasia to allow the lower oesophageal sphincter to relax and thus restore passage of food. Current therapies include surgical intervention (myotomy) or balloon dilation. These have disadvantages, such as risks of perforating the oesophagus and the morbidity associated with surgery. Current trials with botulinum toxin A have been promising, but there are drawbacks, especially the relatively short-term effect of this therapy. It is hoped that further studies will show whether this toxin is a safe and efficacious alternative to standard therapies.