Document Detail


Botulinum A toxin as a treatment for overactive rectum with associated faecal incontinence.
MedLine Citation:
PMID:  21689287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Rectal hypercontractility can lead to faecal incontinence (FI). Botulinum toxin (BT) has been used successfully for the treatment of bladder overactivity. This study aimed to evaluate the therapeutic value of intrarectal injections of BT in inhibiting colorectal contractions and relieving FI in patients suffering from FI as a result of overactive rectal contractions.
METHOD: A prospective open study was carried out in Rouen University Hospital. Six patients (four men and two women) with severe FI related to overactive rectal contractions underwent intrarectal submucosal injections of BT placed in three rows of 10, 1-ml injections (50 U/1 ml; Dysport(®)) starting 1 cm above the dentate line and repeated twice, at intervals of 5 cm proximally. The end-points included improvement in the FI score, in faecal incontinence quality of life (FIQL) and of manometric abnormality.
RESULTS: All patients reported improvement in the FI score [18.2±1.1 at baseline vs 9.0±1.7 at 3 months (P=0.04)] and in FIQL. Rectal contractile activity was reduced. The frequency of contractions remained unaffected (28.1±6.6/h; P=0.46 vs baseline). High-amplitude contractions of >50 cmH(2)O were significantly decreased in all patients (16.6±3.9 vs 6.6±4.1/h; P=0.03).
CONCLUSION: Patients with an 'overactive rectum' are a heterogeneous group, with varying causes of dysfunction. The dose of BT used was arbitrarily selected. Nevertheless, the study introduces a further therapeutic option in the treatment of FI caused by rectal overactivity.
Authors:
V Bridoux; G Gourcerol; B Kianifard; J-Y Touchais; P Ducrotte; A-M Leroi; F Michot; J-J Tuech
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  14     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-08     Completed Date:  2012-08-01     Revised Date:  2012-08-03    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  342-8     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.
Affiliation:
Department of Digestive Surgery, Rouen University Hospital, Rouen Cedex, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Botulinum Toxins, Type A / therapeutic use*
Fecal Incontinence / drug therapy*,  physiopathology
Female
Follow-Up Studies
Humans
Male
Manometry
Middle Aged
Neuromuscular Agents / therapeutic use*
Prospective Studies
Quality of Life
Rectum / physiopathology*
Sigmoidoscopy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Neuromuscular Agents; EC 3.4.24.69/Botulinum Toxins, Type A
Comments/Corrections
Comment In:
Colorectal Dis. 2012 Jul;14(7):898-9   [PMID:  22564854 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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