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    botox for anal sphincter

    Has anyone tried it or had any success? I had 100 units of botox injected last week and unfortunately have had no change at all. The botox was however injected a little farther up the anal canal though (at the dentate line). and i might ask to have it done again towards the anal ring/opening.

    I have sensation in my rectum and I find the tightness extremely uncomfortable.
    It has only started to get tight over the last 4 months and seems to be here to stay. Valium helps just a little but i fear being on a high long term dose.

    jason
    C3/4 Incomplete. Ependymoma tumor, syrinx from C to T.

    #2
    I don't have any experience with Botox and the anal sphincter, but I did a quick internet search on the topic and found that Botox is frequently used to paralyze the anal sphincter in the case of trying to heal an anal fissure. Botox has become an interim step in the treatment of anal fissures to try to avoid an sphincterotomy which is not reversible. If the Botox injection is successful in a patient, the fissure will usually heal by the time (5-8 months) the effects of Botox wear off. You may be right that the Botox was injected in the wrong area in your case. The literature I read talked about injecting Botox directly into the anal sphincter for this treatment.

    Who (what kind of a doctor) did you consult for this procedure? I would suggest that the best physician for this procedure might be a bowel and rectal surgeon.

    All the best,
    GJ

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      #3
      No experience, Seawalker, but I'm interested in your experience. My spasticity problems are with the colo-rectal sphincter, which some days is clenched so tightly that I'm unable to pass gas.

      [PS-Had a good laugh after skimming your OP too quickly. Misread that you had the botox injected at the 'detente' line rather than the 'dentate' line. God, how I wish I could achieve detente in/with my ass!]
      It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

      ~Julius Caesar

      Comment


        #4
        What was the reason for having Botox used? If not done correctly for someone with SCI, it can cause a totally flaccid anal sphincter, which would make bowel management much more problematic. It is usually reserved for treatment of anal fissures. Is that what you have?

        Botox for any purpose usually takes 7-10 days to start working.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

        Comment


          #5
          KLD what would be a correct way to avoid a totally flaccid sphincter? I don't think anyone knows how much or how patient will respond to botox right? 100 units of botox is the standard dose im told.

          Botox is a last ditch effort before colostomy. I should mention that I am an incomplete. I have full abdomen strength and can bear down during a BM with the same force as an AB. But since SCI things down there are out of sinc. My pelvic floor and anal ring have become spastic and now hypertonic. Its complicated. I have pardoxical contraction of my puborectalis, or my internal sphincter is not relaxing enough. now my anal ring is tight. I have had a small fissure from straining, but thats not the sole reason for the botox. The anal ring stays tight as if the fissure was still there but its not. At least not visable. They can come and go if they are small and that may be part of it.

          I am in a position where I have some sensation in my rectum and full strength to push. But at the same rate things are hypersentive. Just sticking a finger in my rectum with 4 percent lidocane jelly still causes me pain and my muscle to grip down on the finger, plus pain. So, thats the reason for the botox. I can only try to keep my stool soft. I can not use anything in my rectum, the muscles will just clamp down. Like you hipcrip, I have trouble passing gas and even liquid.

          My sci neurologist at kennedy krieger wants me to try a baclofen pump for my rectal spacticity. I posted about this before.

          The way I see it, if I am considering a colostomy, I mind as well try everything first right?
          Last edited by seawalker; 20 Oct 2011, 3:39 PM.
          C3/4 Incomplete. Ependymoma tumor, syrinx from C to T.

          Comment


            #6
            Hey...we ave used botox in the rectum for my child, who was lots of pain from not passing gas etc. he is 50lbs and the surgeon gave him 200 units of botox. It worked great, he was already incontinent so the frequency of bowels was often. However, he had the best 4 months pain free and we just did another round of botox, 4 months later.
            You probably did nojt get enough botox to make a difference.

            Have you had botox since your last post?

            Comment


              #7
              hello, I had that tight sphrinter really bad from being spastic. i went to a colo rectal dr. had a lot of tests done to make sure no problems other then spastic. He got a compound made from vaseline and nitro glycerin for me, i put some on a q tip and put it up around. you dont use more then what fits on a q tip it relaxes that area. it really works. botox fro me iwouldnt be able to work out at the gym i would be affraid of accidents. you use juat a little you use to much might get a headach

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                #8
                I went and saw surgeon yesterday as have had pain in anus that has been consistent for 4 days now, got a bit aggressive with dig stim and had flecks of blood but none since. Rectum is very tight which the surgeon noted and although I have aching there before it usually went away in about 2 days. Have taken some stool softener to try and ease things and have good fiber diet with good hydration. The surgeon put the scope up there but said he could not inspect the full length of canal as mine was long and he had a short scope. I use MB and was wondering if the use of these would aggravate the fissure if it did turn out I had one ??

                Comment


                  #9
                  Botox is currently state-of-the-art for treatment of anal fissures. You do want to have it done by an experienced colorectal surgeon who knows how to limit the dose so that you don't have a totally flaccid sphincter, as this can lead to major problems with bowel management and accident prevention.

                  Any chemical irritant (most suppositories) or mechanical irritation (dig stim, manual removal, etc.) of the anus can make fissures worse.

                  (KLD)
                  The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                  Comment


                    #10
                    How does one deal with the suppository issue if one has a fissure, you cannot exactly stop using them for BM ?? Checked with colorectal guy this morning and he is satisfied that I do not have a fissure which for me is a relief given what I have read about them. He said that I should talk to the neuro guys to see if the pain is in fact neuropathic so I do not have an answer yet as to why my tail end was aching for the last for days even though Anusol did seem to me to make the feelings subside.
                    Last edited by gommer; 3 Nov 2016, 3:34 PM.

                    Comment


                      #11
                      Very interesting, the idea of nitroglycerin/Vaseline in a compound that can be applied just when you need it, such as when doing your bowel routine. Most of us with SCI and spasticity do suffer from problems with being able to pass stool with weak suppository triggered bowel contractions and a strong anal sphincter.

                      I never heard of that. Would there be any downside to this? Would the area being relaxed, namely that area within digital reach, not be important for triggering a contraction in moving the bowels. I don't think so, as I think the contractions that are important are higher up in the rectal vault.

                      Comment


                        #12
                        Keep in mind that it is unsafe to use nitroglycerine in any form if you have taken or will take any of the oral ED drugs (Viagra/Levitra/Cialis) within 24 hours.

                        (KLD)
                        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                        Comment


                          #13
                          I have seen it repeated a number of times on the forum that the consistency of stool is also important, it is more difficult if either to hard or to soft, it is that soft/firm stool that you are looking for (gives the bowel walls something to push easily)

                          Comment


                            #14
                            I had Dr. Linsemeyer at Kessler inject me a few times. Unfortunately no success after a couple weeks. The problem we discovered is Botox is nothing more then animal fat. They inject it to make the walls tighter but your catheters end up opening the canals after awhile. So it is a quick fix. Some people have claimed to had success and that is great. For me it was not worth it. I wish you well. Maybe it will work. Its worth a try. It sucks to leak.

                            Comment


                              #15
                              Originally posted by JoeMonte View Post
                              I had Dr. Linsemeyer at Kessler inject me a few times. Unfortunately no success after a couple weeks. The problem we discovered is Botox is nothing more then animal fat. They inject it to make the walls tighter but your catheters end up opening the canals after awhile. So it is a quick fix. Some people have claimed to had success and that is great. For me it was not worth it. I wish you well. Maybe it will work. Its worth a try. It sucks to leak.
                              I assume you are talking about bladder Botox. This thread is about its use for treatment of anal fissures. It has nothing to do with use in the bladder.

                              (KLD)
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                              Comment

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