Botulinum Toxin Reduces Dysphagia in Patients With Nonachalasia Primary Esophageal Motility Disorders  Tim Vanuytsel, Raf Bisschops, Ricard Farré, Ans Pauwels, Lieselot Holvoet, Joris Arts, Philip Caenepeel, Dominiek De Wulf, Kostas Mimidis, Nathalie Rommel, Jan Tack  Clinical Gastroenterology and Hepatology  Volume 11, Issue 9, Pages 1115-1121.e2 (September 2013) DOI: 10.1016/j.cgh.2013.03.021 Copyright © 2013 AGA Institute Terms and Conditions

Figure 1 The effect of BTX or sham injection on the (A) total symptom score and the (B) total dysphagia score. The numbers next to the connecting line indicate the number of subjects if several patients had the same evolution of the symptom score. Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions

Figure 2 Long-term prognosis after BTX injection in (A and C) group 1 (BTX first) (white bars) and (B and D) group 2 (sham first) (shaded bars). *P < .05; **P < .01. Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions

Figure 3 Total symptom score, total dysphagia score, and symptom scores for dysphagia for solids and liquids and chest pain at 1 month after treatment with BTX (white bar) or sham injection (shaded bar). Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions

Figure 4 Responder rates, defined by a modification of the Vantrappen criteria for achalasia, in group 1 (BTX first; solid line) and group 2 (sham first; dashed line). Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions

Figure 5 Manometry before and after BTX injection. (A and B) Maximal distal amplitude in (A) group 1 (white bars; BTX first) and (B) group 2 (shaded bars; sham injection first). (C and D) Representative pictures of a patient with jackhammer esophagus (C) before and (D) 1 month after BTX. Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions

Supplementary Figure 1 CONSORT flow diagram. Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions

Supplementary Figure 2 Weight changes 1 month after BTX (white bar) and sham injection (shaded bar). Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions

Supplementary Figure 3 Long-term prognosis after BTX injection in patients with manometry-confirmed distal esophageal spasm in (A and C) group 1 (BTX as the first treatment; n = 7; white bars) and (B and D) group 2 (sham as the first treatment; n = 8; shaded bars). *P < .05; **P < .01, Friedman test with Dunn correction for multiple testing. Clinical Gastroenterology and Hepatology 2013 11, 1115-1121.e2DOI: (10.1016/j.cgh.2013.03.021) Copyright © 2013 AGA Institute Terms and Conditions