The Use of Botulinum Toxin as an Adjuvant in Managing Children with Chronic Constipation and Obstructed Defecation

Abstract

ediatric functional constipation (FC) is a challenging pediatric problem with bad impact on quality of life affecting both the child and family; it is a complex disorder of multifactorial etiology and pathophysiology. The diagnosis of functional defecation disorders is primarily based on history and physical examination. Many symptoms-based systems have been instructed for clarified definitions such as ROME, PACCT and NICE criteria. The protocol of management of functional constipation usually includes; disimpaction enemas, feeding regulations, bowel diaries and laxatives. Novel therapies are available, one of them is intra-anal sphincteric Botulinum toxin injection, yet their effects still questionable.