Botulinum toxin type A injections for treatment of chronic anal fissures

An anal fissure is one of the most common diseases of the anal canal with the incident rate of 20–23 cases per 1000 citizens. Most of acute anal fissures are healed spontaneously but a few of them can become chronic process. Chronic anal fissures are characterized by any two of the criteria: pain after defecation lasts longer than 3 months, sentinel pile is present, fibers of internal sphincter at the base of the anoderm.The spasm of the internal sphincter is a guiding pathogenetic mechanism in the development of chronic anal fissures. It leads to circulatory disorder in the anoderm and non-healing wounds. Therefore, the treatment of anal fissures primarily must be focus on eliminating of internal sphincter spasms and then excising of fissures.Recently, botulinum toxin type A injection in treatment of chronic anal fissures has become popular as a noninvasive method of eliminating internal sphincter spasms.Botulinum toxin as a medical agent has been studied since the late 1960s. Botulinum toxin type A has been used to treat of various pathologies including coloproctology diseases for more than 40 years.The botulinum toxin injections make the internal sphincter relax, and as a result create optimal conditions for healing chronic anal fissures.Using of botulinum toxin type A does not cause dangerous complication. Fecal incontinence after using botulinum toxin is transitory.The review describes the use of botulinum toxin type A injections to treat chronic anal fissures.

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Effect of the botulinum toxin injections and endoscopic pneumocardiodilation on symptoms severity and treatment outcomes among patients with primary esophageal sphincter achalasia

Journal of Education, Health and Sport ◽

10.12775/jehs.2021.11.10.023 ◽

2021 ◽

Vol 11 (10) ◽

pp. 252-262

Author(s):

A. Kiosov

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Injection ◽

Botulinum Toxin Type A ◽

Clinical Effectiveness ◽

Type A ◽

Botulinum Toxin Type ◽

Results Of Treatment ◽

Endoscopic Method ◽

Undigested Food ◽

Botulinum Toxin Injections

Achalasia is a disorder of esophageal motility, which is manifested by symptoms of dysphagia, belching undigested food, respiratory symptoms (night cough, recurrent aspiration and pneumonia), chest pain and weight loss. Aim of the study. To determine the possibilities and clinical effectiveness of combined approaches in the treatment of cardiac achalasia using endoscopic pneumocardiodilation and injections of botulinum toxin type A "Dysport" at various stages of the disease. Materials and methods. Injections of the drug botulinum toxin type A "Dysport" and balloon endoscopic pneumocardiodilation (EPCD) were used. The contents of the vial with botulinum toxin were diluted in 0.9% sodium chloride solution to obtain a solution containing 60 UA in 1 ml. In each of the four quadrants of the LES, 2 injections of 0.5 ml of the drug "Dysport" were made with a concentration of a solution of 30 UA in 0.5 ml at a distance of 1 cm from one another. The total dose was 250 units. The technique of isolated EPCD, was carried out with a Witzel balloon dilator, 40 mm in diameter, it required a thorough preoperative examination of the patient, including an assessment of the general condition, the presence and severity of body weight deficiency, water-electrolyte, protein, achlorhydric manifestations of the disease, as well as the propulsive ability of the esophagus through X-ray examination. Results. The combined endoscopic method significantly improves the results of treatment of esophageal cardiac achalasia, having a direct impact on the pathogenetic mechanisms of its development. Given the effectiveness of treatment of esophageal cardiac achalasia by botulinum toxin injection and pneumocardiodilation, this method can be used in patients with comorbid pathology and high surgical risk as an alternative to laparoscopic Heller procedure (cardiomyotomy), especially in older patients. Unsatisfactory results of the combined endoscopic method of treatment of stage III-IV cardiac achalasia for up to 2 months are an indication for surgical treatment of this pathology. Conclusions. Given the significant increase in knowledge about this nosology in recent years, there is a need for a comprehensive, evidence-based study of new promising treatments for patients, covering all aspects of the disease.

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Beneficial effects of botulinum toxin type A in trigeminal neuralgia

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2008000400012 ◽

2008 ◽

Vol 66 (3a) ◽

pp. 500-503 ◽

Cited By ~ 44

Author(s):

Carlos Zúñiga ◽

Sergio Díaz ◽

Fabián Piedimonte ◽

Federico Micheli

Keyword(s):

Botulinum Toxin ◽

Trigeminal Neuralgia ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Clinical Effects ◽

Beneficial Effects ◽

Pain Syndromes ◽

Idiopathic Trigeminal Neuralgia ◽

Botulinum Toxin Injections

Botulinum toxin has been thoroughly studied as a potential tool in the treatment of several pain syndromes. Therefore, we assessed the clinical effects of botulinum toxin type A injections in 12 patients with otherwise unresponsive idiopathic trigeminal neuralgia. Patients were infiltrated with 20-50 units of botulinum toxin in trigger zones. Those who presented with mandibular involvement were also infiltrated in the masseter muscle. The patients were assessed on a weekly basis using the Visual Analogic Scale for pain. Ten of our patients reported a significant benefit from botulinum toxin injections, with reduction or even disappearance of pain, and remained pain free for as long as 60 days. Our findings suggest that botulinum toxin may represent a useful therapeutic tool in the management of patients with this entity.

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The treatment of chronic anal fissures with fissure excision and Botulinum Toxin Type A injection

http://isrctn.com/ ◽

10.1186/isrctn97413456 ◽

2018 ◽

Author(s):

Eugene Zharkov ◽

Asmat Burtseva ◽

Sergei Frolov

Keyword(s):

Botulinum Toxin ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Anal Fissures

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The use of combination therapy in the treatment of lower limb spasticity among patients after stroke - a review of literature

Rehabilitacja Medyczna ◽

10.5604/01.3001.0013.0875 ◽

2019 ◽

Vol 23 (2) ◽

pp. 36-41

Author(s):

Kinga Opoka ◽

Magdalena Filip ◽

Elżbieta Mirek ◽

Beata Mazurek ◽

Szymon Pasiut

Keyword(s):

Botulinum Toxin ◽

Combination Therapy ◽

Lower Limb ◽

Botulinum Toxin Type A ◽

Type A ◽

Botulinum Toxin Type ◽

Review Of Literature ◽

Limb Spasticity ◽

Lower Limb Spasticity ◽

Botulinum Toxin Injections

Stroke is not only a medical problem, but also, due to the permanent disability of patients, a significant social issue. Therefore, gait disturbances resulting from lower limb muscle spastici-ty are a common subject of research. The ambiguities in the scientific literature have become justification for the creation of this systematic review, the aim of which is to collect and ana-lyse works describing the efficacy of combination therapy - including Botulinum toxin type A injections and physiotherapy following stroke. The following databases were searched: Pub-Med, EBSCO, Springer Link (date of access: 24 Jan. 2019). It was assumed that analysis will include scientific works published in English from 2000 to date (in accordance with search date). For the entry "combination therapy" (Botulinum toxin injections and physiotherapy), the search was conducted using the following keywords: physical therapy, Botulinum toxin type A, Botox A, lower limb, gait, brain, stroke, hemiparesis. Out of all the elaborate articles, 7 concerning combination therapy were ultimately evaluated. Analysis of the collected works indicates the effectiveness of combination therapy in the area of improving structural parame-ters. Some of the works prove that this type of therapy also improves functional indices and leads to increased activity of patients. We could not collect satisfactory evidence confirming its effectiveness in terms of increasing social participation and improving the quality of life of patients. This review indicates the need to develop specific therapeutic protocols accurately describing both Botulinum toxin injections and physiotherapy - taking the intensity, duration and type of therapy into account. Opoka K., Filip M., Mirek E., Pasiut S. The use of combination therapy in the treatment of lower limb spasticity among patients after stroke − a review of literature. Med Rehabil 2019; 23(2): 36-41. DOI: 10.5604/01.3001.0013.0875 This article is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License CC BY-SA (http://creativecommons.org/licenses/by-sa/4.0/) null

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