Most Read Articles
Elvira Manzano, 3 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
11 hours ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, 13 hours ago
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.

Internal anal sphincter botox relieves pain, improves bowel in chronic obstructive defecation

27 Jul 2017

Ultrasound-guided botulinum toxin (botox) injection into the internal anal sphincter (IAS) is safe and effective for obstructive defecation as a result of Hirschsprung Disease (HD), a new study shows.

Over a median follow-up of 87 (31 to 127) weeks, improvements in enterocolitis-related symptoms were observed in 82 percent of 30 botox injection procedures administered to 12 paediatric patients (mean age 3.1±2.5 years).

Of the 30 percent of patients who reported painful bowel movements before operation, 78 percent reported improvements after operation. On the other hand, 47 percent presented with no spontaneous bowel movement before injection; 65 percent of these cases were resolved after operation.

Ultrasound was used for guidance in 43.3 percent (n=13) of the cases, of which 76 percent (n=10) showed clinical improvements after operation. By comparison, only 65 percent (n=11) of the nonultrasound-guided procedures showed improvements (p=0.69).

However, significantly more ultrasound-guided procedures did not require additional procedures as compared with the nonultrasound-guided procedures (p=0.009). There were also significantly less injections in the ultrasound-guided procedures (p=0.027).

There was no significant association between ultrasound use and improvements in spontaneous bowel movements (p=0.49), enterocolitis (p=0.87) and time to next procedure (p=0.52).

Paediatric patients recruited all received botox injection to the IAS because of IAS achalasia (n=5) or nonrelaxing IAS after HD surgery (n=7). All procedures were performed under general anaesthesia. Primary outcome was short-term improvement, while complications, number of injections and time to next procedure were secondary outcomes.

A median of two injections (one to three) yielded improvements after 70 percent (n=21) of the procedures. Secondary procedures, delivered at a median of 99 (38 to 137) days, were required in 87 percent of the patients.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Elvira Manzano, 3 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
11 hours ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, 13 hours ago
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.