The treatment of internal anal sphincter achalasia with botulinum toxin

Internal anal sphincter (IAS) achalasia is a disorder of defecation in which the IAS fails to relax. Botulinum toxin (BT), which has been successfully used to relax the anal and lower esophageal sphincters, was injected twice into the IAS of one adolescent and three infants with manometric, radiolog...

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Bibliographic Details
Published in:Pediatric surgery international 2001-09, Vol.17 (7), p.521-523
Main Authors: MESSINEO, Antonio, CODRICH, Daniela, MONAI, Margherita, MARTELLOSSI, Stefano, VENTURA, Alessandro
Format: Article
Language:English
Subjects:
Biological and medical sciences
Botulinum Toxins, Type A - pharmacology
Botulinum Toxins, Type A - therapeutic use
Child
Constipation - drug therapy
Defecation
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Infant, Newborn
Male
Malformations
Medical sciences
Muscle, Smooth - drug effects
Neuromuscular Agents - pharmacology
Neuromuscular Agents - therapeutic use
Pilot Projects
Rectal Diseases - drug therapy
Stomach, duodenum, intestine, rectum, anus
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
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Summary:Internal anal sphincter (IAS) achalasia is a disorder of defecation in which the IAS fails to relax. Botulinum toxin (BT), which has been successfully used to relax the anal and lower esophageal sphincters, was injected twice into the IAS of one adolescent and three infants with manometric, radiologic, and in 2 cases histochemical diagnosis of anal achalasia: in the adolescent a third injection was necessary. Spontaneous defecation was achieved in all patients following the second injection. In one case a diagnosis of short-segment Hirschsprung's disease was obtained after the second injection. Local infiltration of BT into the IAS proved effective in the treatment of IAS achalasia. Double-blind studies and longer follow-up periods are needed to better evaluate these preliminary results and define the limits of this promising therapy.
ISSN:0179-0358
1437-9813
DOI:10.1007/s003830100583