The use of botulinum toxin in children with chronic constipation

Abstract

Background: Conventional therapy of childhood constipation was based on dietary manipulation, stool softeners and oral laxatives. Although these forms of medications are successful in the majority of cases, still small subgroup of patients may fail to respond to this treatment. The aim of this study was to evaluate the role of botulinum toxin in relieving the symptoms of those patients.Methods: This study was conducted on 20 cases with chronic constipation that fail to respond to conventional medical treatment. Cases under went any previous surgical maneuver will be excluded from study. Anal dilatation was started by Higar dilators then small self-retaining anal retractors were introduced and four injections were made into the four quadrants of the anal canal and rectum at the level of IAS (internal anal sphincter).Results: twenty cases were included (14 males and 6 females) with age ranged from 8 months to 6 years. The botulinum injection per patients ranged from 1 to 2 injections. The response rate to this treatment was excellent in 6 cases and good in 12 cases and poor in 2 cases. No systemic or local complications occurred in any patients.Conclusions: botulinum toxin injection could be safe and effective treatment of chronic constipation in infants and children.