Treatment of Achalasia in Chagas' Disease with Botulinum Toxin

To the Editor: Chagas' disease, which is common in Brazil, often involves the esophageal neural plexus, resulting in clinical, manometric, and histologic findings resembling those of achalasia. Therefore, its management could be similar. Patients with achalasia or Chagas' disease involving the esophagus may be treated with drugs, endoscopic dilation, or surgery. Pasricha et al. 1 described the successful treatment of achalasia by the endoscopic injection of botulinum toxin into the lower esophageal sphincter; their initial report has now been confirmed by their more extensive studies [reported in this issue of the Journal 2 ]. We used the same technique to treat a . . .