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Medical Forum / General / General / February 2009Question about endoscopy with Botox
I was wondering if anyone has had this procedure. My husband has been having a lot of trouble swallowing. Half the time he end up throwing up because the food or liquid gets stuck in his throat. An endoscopy showed that the valve that connects the esophagus to the stomach does not open. The are going to inject Botox into the valve to relax it. I was wondering how long after the procedure the valve would open? I've left messages for the doctor but haven't heard back yet. I do understand that it's quite successful, although it is only temporary. My husband has cancer. He has lost an enormous amount of weight. Partly from the cancer of course, but not being able to eat normal food hasn't helped at all. Even water can be a problem. In article <05ac95cb-04c5-4713-85c7-35173be02420@f3g2000yqf.googlegroups.com>, > I was wondering if anyone has had this procedure. > [quoted text clipped - 11 lines] > Partly from the cancer of course, but not being able to eat normal > food hasn't helped at all. Even water can be a problem. I presume that your husband has been diagnosed with achalasia? What kind of cancer does your husband have? What were the results of his manometry testing? What did his barium swallow show? Injecting the lower esophageal sphincter with botox is a bad idea in an otherwise healthy patient. It is temporary, will have to be repeated every 2-3 months, and can make the operation that will ultimately be required increasingly difficult with each injection. That operation (Heller esophagomyotomy) is done laparoscopically and typically is an overnight stay in the hospital. OTOH, in a patient that is terminal and only has a year or less to live, botox could be reasonable palliation. HMc > In article > <05ac95cb-04c5-4713-85c7-35173be02420@f3g2000yqf.googlegroups.com>, [quoted text clipped - 31 lines] > > HMc Thank you, Howard. He has lung cancer (type unknown), spread to the liver and the bones. He's 78 and has had ""very mild" congestive heart failure. Protein in the urine The reading was 465. After 3 months on Diovan (which also makes him tired) the protein level was almost normal at 34. His potassium was also a little high. It is also at normal levels now that I've cut down on many high potassium foods. There is some fluid around the lung area. he takes Coumadin for chronic atrial fibrillation (afib for more than 40 years) Very short of breath - plans to remove fluid from around the lungs. Tough situation, poor prognosis, I would think.. I think she will be asking the oncologist Tuesday about getting help from hospice. J - supplying additional information in case she has other questions > Thank you, Howard. > He has lung cancer (type unknown), spread to the liver and the bones. [quoted text clipped - 13 lines] > > J - supplying additional information in case she has other questions Tough situation indeed, and with this additional information, it's clear that operative intervention (Heller esophagomyotomy) is not a good choice for this patient. Botox injection of the LES could be a good palliative solution to improve swallowing and improve quality of life in this case, but only if the difficulty swallowing is related to excessive intrinsic LES pressure, and not external compression of the distal esophagus by tumor. A barium swallow alone may not be sufficient to make that distinction. HMc |
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