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Year : 2019  |  Volume : 8  |  Issue : 1  |  Page : 289-297

Bridging therapy for achalasia in a second trimester pregnant patient

Department of Gastroenterology, Naval Medical Center, San Diego, Bob Wilson Drive, San Diego, California, United States

Correspondence Address:
Zachary S Neubert
Department of Gastroenterology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego - 92134, California
United States
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_389_18

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We present the case of a 28-year-old female who presented for primary care at 22-week gestation with type II achalasia and worsening solid/liquid dysphagia leading to pregnancy weight loss. Considering that durable therapies such as surgical myotomy and pneumatic dilatation have considerable risk, botulinum A toxin injection was selected as a temporizing bridging therapy. She had an uncomplicated post procedure course and had significant rapid improvement in dysphagia symptoms, which enabled her to progress to normal peripartum weight. This case highlights the need for early recognition of achalasia and an unique niche for use of botulinum toxin A as a temporizing therapy in this risk averse population.

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