Researchers are testing rectal injections of Botox to see if it can help manage fecal incontinence in patients. So far, the results are promising. If future studies prove successful, doctors could offer patients new ways to manage this difficult-to-control condition.[]
In a randomized, double-blind, placebo-controlled study, researchers treated approximately 200 patients with fecal incontinence using Botox or a placebo. Ninety-six patients received Botox and 95 received a placebo treatment after nine patients withdrew from the trial before receiving the injection.[]
The Botox group received a submucosal injection of 200 units of botulinum toxin type A (BoNTA), and the placebo group received the same amount of saline. Data was collected blindly for six months, after which participants were unmasked and members of the placebo group were offered Botox treatment and followed for an additional six months for safety. The study was conducted in France from November 25, 2015 to November 25, 2020.[]
The results showed that Botox injections were effective in reducing symptoms of urge fecal incontinence and urge fecal incontinence in people. Now, researchers say this treatment may hold promise as a first-line drug for urge urinary incontinence.[]
Botox has been used for many years as a treatment for urge incontinence, with “good results and few side effects,” giving researchers increased confidence in its success in treating fecal incontinence. Other types of rectal injections, such as Solesta injections, are also used for fecal incontinence.[]
Dr Brian Curtin, MHSc; He is a board-certified gastroenterologist and director of the Center for Neurogastroenterology and Digestive Motility at the Melissa L. Posner Institute for Digestive Health and Liver Diseases at Mercy Medical Center in Baltimore, Maryland. He says he often uses Soresta injections to help patients with . . According to his experience, this gives good results.
Solesta is an expanded dextranomer gel that Dr. Curtin injects into the subcutaneous tissue in the distal rectum of treated patients. He says it’s important to assess the condition of the patient’s anal sphincter when administering the injection. This may provide information about the cause of incontinence and help predict whether treatment will be successful.
“I always perform anorectal manometry and sigmoidoscopy before injections to rule out structural disease and confirm the presence of a weakened anal sphincter,” Dr. Curtin explains. . “This intervention is less successful if the cause of incontinence is due to incoordination of defecation.”
Dr. Curtin added that he estimates that more than 80 percent of patients will experience approximately one year of symptom relief after one treatment.
“I have several patients who come back to me every year for injections,” Dr. Curtin says. “Faecal incontinence is a very difficult problem to solve completely, but in my experience injections reduce the frequency and severity of incidents and reduce the need for antidiarrheal drugs such as Imodium.”
Dr. Curtin has not personally treated a patient who developed serious side effects after treatment.
The most frequently reported non-serious adverse event in studies of Botox injections was constipation, which could, depending on interpretation, imply that the treatment is effective. Too good.
Louise HateleyThe physiotherapist and director of Australia’s In Stride Health Clinic says she is optimistic about the future of fecal incontinence treatment.
“Fecal incontinence can have a significant impact on quality of life, so it’s important that treatment options are advanced,” Dr Hateley says. “While pelvic floor exercises and Pilates are important standard physical therapy approaches to addressing discomfort, rectal injections may represent a new option for those suffering from this disease. It is often difficult to treat with technology.”
Hatley emphasizes the need for further research into the safety and effectiveness of the treatment to best care for patients in need.
Researchers say further research is needed to optimize delivery of the treatment, including identifying specific injection sites in the body and recommended doses. Future research should continue to assess risks, evaluate long-term efficacy of treatments, and identify the best candidates.
Depending on future research developments, this treatment could be offered to patients instead of or in addition to existing options.
what this means for you
Researchers are testing rectal Botox injections for fecal incontinence. Although the results are promising, further research is needed to confirm safety and efficacy. If this happens, you may be able to offer this treatment to your patient.