TY - JOUR
T1 - Hypercontractile esophageal motility disorder or functional esophageal symptoms and unrelated hypercontractility?
AU - Bredenoord, Albert J.
N1 - © 2019 John Wiley & Sons Ltd.
PY - 2019/5
Y1 - 2019/5
N2 - In this issue of the journal, Mion and coworkers describe 23 patients with dysphagia and/or thoracic pain and hypercontractile esophageal motility disorders who were either treated with botulinum toxin 100 U or underwent a sham procedure. The surprising outcome of the study was that both active botulinum toxin treatment and sham treatment resulted in a significant reduction in symptoms and manometric abnormalities after 3 months, with no difference between the two arms. One can interpret the lack of effect of botulinum toxin over placebo as indicative of the benign natural history of hypercontractile esophageal motility disorders or be convinced that many patients with hypercontractility on manometry actually have functional symptoms not related to the manometric findings, and thus, treatment of hypercontractility is not more effective than placebo. Either way, invasive, irreversible treatments with potential risks for complications seem difficult to justify in these patients.
AB - In this issue of the journal, Mion and coworkers describe 23 patients with dysphagia and/or thoracic pain and hypercontractile esophageal motility disorders who were either treated with botulinum toxin 100 U or underwent a sham procedure. The surprising outcome of the study was that both active botulinum toxin treatment and sham treatment resulted in a significant reduction in symptoms and manometric abnormalities after 3 months, with no difference between the two arms. One can interpret the lack of effect of botulinum toxin over placebo as indicative of the benign natural history of hypercontractile esophageal motility disorders or be convinced that many patients with hypercontractility on manometry actually have functional symptoms not related to the manometric findings, and thus, treatment of hypercontractility is not more effective than placebo. Either way, invasive, irreversible treatments with potential risks for complications seem difficult to justify in these patients.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064482054&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30993816
U2 - https://doi.org/10.1111/nmo.13594
DO - https://doi.org/10.1111/nmo.13594
M3 - Editorial
C2 - 30993816
SN - 1350-1925
VL - 31
SP - e13594
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
IS - 5
M1 - e13594
ER -