Intraluminal Neural therapy in Gastroenterology – Three Case Reports

摘要

Background: Neural therapy is a widely used procedure. The treatment system in which procain is injected into certainneuromodulative trigger of the body, such as scars or peripheral nerves, in an attempt to relieve chronic pain and illness ispracticed in many countries and there is much experience in clinical application. However, its effectiveness has not yetbeen scientifically proven. In this abstract we present three case reports from patients, who were treated with intraluminalneural therapy.Case reports: The first case is a 39-year-old patient, who was injured by a gunshot which penetrated the abdominal wall andthe rectum. He developed a chronic pain syndrome with persistent severe rectal pain during and up to 30 minutes afterdefecation. Outpatient treatment for more than 10 years with analgesic agents, glucocorticoids, and salicylates did notshow sufficient therapeutic benefit. During flexible rectoscopy, a rectum scar was located and a local injection of procaineinto the rectum scar was performed. The patient described a strong and sharp pain during the infiltration which lasted about5e10 seconds. Subsequently, the pain resolved. After the intervention as well as at discharge, the patient was completelypain-free. The second case is a 27-year-old female patient suffering from esophageal atresia with massive limiting symptoms such as heartburn, vomiting, regurgitation, nausea, and stomach cramps despite maximal conservative therapy afterpostpartal gastric pull-up surgery. As part of a gastroscopy, the patient received an endoluminal procaine infiltration intothe scarred anastomotic region, whereupon the clinical symptoms significantly reduced and also remained stable in thelonger term. The third case is a 62 year old female who underwent subtotal colectomy due to a chronic active Crohnsdisease and subsequently developed a chronic anastomositis (Rutgeers Score 2) with associated chronic abdominal pain. Thepatient experienced a significant reduction of the abdominal pain after endoluminal procaine infiltration into the inflamedanastomotic region.Conclusion: The three case reports are promising examples for the successful endoscopic neural therapy of an intraluminalfocus causing a chronic pain syndrome refractory to conventional analgesic or anti-inflammatory treatment and the successful endoluminal infiltration of procaine into scarred tissue of an enteral anastomotic region after surgical gastric pull-upinducing a relevant improvement of symptoms. Further research in the field is highly warranted.