The Use of Botulinum Toxin as an Adjuvant in Managing Children with Chronic Constipation and Obstructed Defecation | ||||
| The Medical Journal of Cairo University | ||||
| Article 8, Volume 88, September, September 2020, Page 1503-1506 PDF (199.61 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjcu.2020.116240 | ||||
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| Authors | ||||
| AYMAN A. TALAAT, M.D.; AYMAN A. ALBAGHDADY, M.D.; AHMED B. ARAFA, M.D.; MOHAMMAD R. EL-SHAHAWY, M.Sc. | ||||
| The Departments of General Surgery* and Pediatric Surgery**, Faculty of Medicine, Ain Shams University | ||||
| Abstract | ||||
| Abstract Background: Pediatric chronic constipation and obstructed defecation is a challenging problem, with bad impact on quality of life affecting both the child and family. It is a complex disorder of multifactorial etiology and pathophysi-ology. Many symptoms-based systems have been instructed for clarifying definitions for chronic constipation and obstruct-ed defecation such as ROME IV criteria, PACCT criteria, NICE guideline. Most protocols of management of functional constipation usually include; disimpaction enemas, feeding regulations, bowel diaries and laxatives. Aim of Study: To evaluate the effectiveness of adding anal Botox injection to those already following management plan for pediatric age group suffering from chronic constipation and obstructed defecation. Patients and Methods: The current study included 40 children with functional constipation, and obstructed defeca-tion. The study started in April 2017 and completed the patients follow-up in November 2019. Bowel management program was applied with Botulinum toxin injection. Patients were followed-up at 2 months, and 6 months using Rintala Scores. Results: The study included 45% female members and 55% male ones, with age range between 3-12 years. Improve-ment was achieved in 22.5% of children after 2 months of the management, all patients were followed-up at least for 6 months period, with a mean follow-up of 11.35 months. Rintala scores at initial presentation, 2 months and 6 months follow-up showed improvement. Overall, across all the study subjects, females did better and showed more improvement. Conclusion: This study has confirmed that BT injection did not add any significant effect, to children with obstructed defecation and chronic FC. | ||||
| Keywords | ||||
| Pediatric constipation; Chronic constipation; Functional constipation; Obstructed defecation; Anal sphincteric Botox injection | ||||
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