A comparative observational study on intrasphincteric injections with Botulinum toxin vs. enteral neuromodulation in chronic refractory constipation

Walther M, Müller H, Weiß C, Carbon R, Diez S, Besendörfer M (2023)

Publication Type: Journal article

Publication year: 2023

Journal

BMC Pediatrics BioMed Central

Book Volume: 23

Article Number: 448

Journal Issue: 1

DOI: 10.1186/s12887-023-04217-5

Abstract

Purpose: Botulinum toxin injections in the anal sphincter apparatus (Botox) and enteral neuromodulation (ENM) are options for treatment of refractory chronic constipation. We present a retrospective comparative observational study. Patients and methods: From 2014 to 2022, pediatric patients with chronic constipation were either treated with Botox or ENM with continuation of conservative treatment. Comparison was conducted regarding the primary outcome variables defecation frequency, stool consistency, and abdominal pain. Secondary outcomes were fecal incontinence, enuresis, change of medication and safety of treatment. Results: 19 Botox patients (10 boys, 9 girls, 12 patients with Hirschsprung disease (HD), 7 patients with functional constipation (FC)) were compared to 24 ENM patients (18 boys, 6 girls, 12 HD patients, 7 FC patients). Groups differed significantly in age (5.0 years (Botulinum toxin) and 6.5 years (ENM), mean values, p-value 0.008). Improvement of constipation was seen in 68% (n = 13/19) of Botox and 88% (n = 21/24) of ENM patients (p = 0.153). Influence of etiology on therapeutic effects was not observed. Complications were minor. Conclusions: Botox and ENM can be considered as valuable and effective treatment options in refractory chronic constipation. Prospective, large-population studies should be designed to enable improved evidence.

Authors with CRIS profile

Mona Walther Institute of Human Genetics Sonja Diez Department of Paediatric Surgery Manuel Besendörfer Department of Paediatric Surgery

Involved external institutions

Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Universitätsklinikum Mannheim DE Germany (DE)

How to cite

APA:

Walther, M., Müller, H., Weiß, C., Carbon, R., Diez, S., & Besendörfer, M. (2023). A comparative observational study on intrasphincteric injections with Botulinum toxin vs. enteral neuromodulation in chronic refractory constipation. BMC Pediatrics, 23(1). https://doi.org/10.1186/s12887-023-04217-5

MLA:

Walther, Mona, et al. "A comparative observational study on intrasphincteric injections with Botulinum toxin vs. enteral neuromodulation in chronic refractory constipation." BMC Pediatrics 23.1 (2023).

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