Skip to main content
SpringerLink
Log in

Botulinum Toxin and Other New Pharmacologic Approaches to Constipation

  • Chapter
Constipation

  • 1315 Accesses

Conclusion

The main thrust of treating patients with chronic constipation remains pharmacologic. Increased use of these agents is appealing because their safety profile is much more acceptable than is the one following colectomy for constipation. Continuing improvements in our knowledge of gastrointestinal motility as well as the physiology of defecation will no doubt help home in on specific pharmacologic targets to benefit these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Lindsey I, Jones OM, Cunningham C, Mortensen NJ McC. Chronic anal fissure. Br J Surg 2004;91:270–279.

    Article  PubMed  CAS  Google Scholar 

  2. Lennard-Jones JE. Constipation. In: Feldman M, Scharschmidt BF, Sleisenger MH, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management, 6th ed. Philadelphia: WB Saunders, 1998:174–197.

    Google Scholar 

  3. Van Ermengem E. Classics in infectious diseases: a new anaerobic bacillus and its relation to botulism. Originally published as “Ueber einen neuen anaeroben bacillus und seine beziehungen zum botulismus” in Zeitschrift fur Hygiene und Infektionskrankheiten 1897;26:1–56. Rev Infect Dis 1979;1:701–719.

    PubMed  Google Scholar 

  4. Burgen AS, Dickens F, Zatman LJ. The action of botulinum toxin on the neuromuscular junction. J Physiol 1949;109:10–24.

    PubMed  CAS  Google Scholar 

  5. Jankovic J, Brin MF. Botulinum toxin: historical perspective and potential new indications. Muscle Nerve 1997;20(suppl 6):S129–145.

    Article  Google Scholar 

  6. Schiavo G, Rossetto O, Santucci A, Dasgupta BR, Montecucco C. Botulinum neurotoxins are zinc proteins. J Biol Chem 1992;267:23479–23483.

    PubMed  CAS  Google Scholar 

  7. Brin MF. Botulinum toxin: chemistry, pharmacology, toxicity and immunology. Muscle Nerve 1997;20(suppl 6):S146–168.

    Article  Google Scholar 

  8. de Paiva A, Meunier FA, Molgo J, Aoki KR, Dolly JO. Functional repair of motor end plates after botulinum toxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their terminals. Proc Natl Acad Sci 1999;96:3200–3205.

    Article  PubMed  Google Scholar 

  9. Scott AB. Botulinum toxin injection of the eye muscles to correct strabismus. Trans Am Ophthalmol Soc 1981;79:734–770.

    PubMed  CAS  Google Scholar 

  10. Brin MF, Blitzer A. Botulinum toxin: dangerous terminology errors [letter]. J R Soc Med 1993;86:493–494.

    PubMed  CAS  Google Scholar 

  11. Wasserman F. Puborectalis syndrome (rectal stenosis due to anorectal spasm). Dis Colon Rectum 1964;7:87–98.

    Article  PubMed  CAS  Google Scholar 

  12. Preston DM, Lennard-Jones JE. Anismus in chronic constipation. Dig Dis Sci 1985;30:413–418.

    Article  PubMed  CAS  Google Scholar 

  13. Hallan RJ, Williams NS, Melling J, Waldron DJ, Womack NR, Morrison JF. Treatment of anismus in intractable constipation with botulinum A toxin. Lancet 1988;338:714–717.

    Article  Google Scholar 

  14. Joo S, Agachan F, Wolff B, Nogueras JJ, Wexner SD. Initial North American experience with botulinum toxin type A for treatment of anismus. Dis Colon Rectum 1996;39:1107–1111.

    Article  PubMed  CAS  Google Scholar 

  15. Maria G, Brisinda G, Bentivoglio AR, Cassetta E, Albanese A. Botulinum toxin in the treatment of outlet obstruction caused by puborectalis syndrome. Dis Colon Rectum 2000;43:376–380.

    Article  PubMed  CAS  Google Scholar 

  16. Ron Y, Avni Y, Lukovetski A, et al. Botulinum toxin type-A in therapy of patients with anismus. Dis Colon Rectum 2001;44:1821–1826.

    Article  PubMed  CAS  Google Scholar 

  17. Albanese A, Maria G, Bentivoglio AR, Brisinda G, Cassetta E, Tonali P. Severe constipation in Parkinson’s disease relieved by botulinum toxin. Mov Disord 1997;12:764–766.

    Article  PubMed  CAS  Google Scholar 

  18. Albanese A, Brisinda G, Bentivoglio AR, Maria G. Treatment of outlet obstruction in constipation in Parkinson’s disease with botulinum neurotoxin A. Am J Gastroenterol 2003;98:1439–1440.

    Article  PubMed  CAS  Google Scholar 

  19. Johansson, Nilsson BY, Holmström B, Dolk A, Mellgren A. Association between rectocele and paradoxical sphincter response. Dis Colon Rectum 1992;35:503–509.

    Article  PubMed  CAS  Google Scholar 

  20. Maria G, Brisinda G, Bentivoglio AR, Albanese A, Sganga G, Castagneto M. Anterior rectocoele due to obstructed defecation relieved by botulinum toxin. Surgery 2001;129:524–529.

    Article  PubMed  CAS  Google Scholar 

  21. Shafik A, El Sibai O. Botulinum toxin in the treatment of nonrelaxing puborectalis syndrome. Dig Surg 1998;15:347–351.

    Article  PubMed  CAS  Google Scholar 

  22. Borodic GE, Johnson E, Goodnough M, Schantz E. Botulinum toxin therapy, immunologic resistance, and problems with available materials. Neurology 1996;46:26–29.

    PubMed  CAS  Google Scholar 

  23. Munchau A, Bhatia KP. Uses of botulinum toxin injection in medicine today. Br Med J 2000;320:161–166.

    Article  CAS  Google Scholar 

  24. Borodic GE, Ferrante R, Pearce LB, Smith K. Histological assessment of dose related diffusion and muscle fibre response after therapeutic botulinum toxin A injections. Mov Disord 1994;9:31–39.

    Article  PubMed  CAS  Google Scholar 

  25. Garner CG, Straube A, Witt TN, Gasser T, Oertel WH. Time course of distant effects of local injections of botulinum toxin. Mov Disord 1993;8:33–37.

    Article  PubMed  CAS  Google Scholar 

  26. Spiller R. Serotonergic modulating drugs for functional gastrointestinal diseases. Br J Clin Pharmacol 2002;54:11–20.

    Article  PubMed  CAS  Google Scholar 

  27. Bulbring E, Crema A. The release of 5-hydroxytryptamine in relation to pressure exerted on the intestinal mucosa. J Physiol (Lond) 1959;146:18–28.

    PubMed  CAS  Google Scholar 

  28. Gershon MD. The roles played by 5-hydroxytryptamine in the physiology of the bowel. Aliment Pharmacol Ther 1999;13(suppl 2):15–30.

    PubMed  Google Scholar 

  29. Lomax RB, Gallego S, Novalbos J, Garcia AG, Warhurst G. L-type calcium channels in enterochromaffin cells from guinea pig and human duodenal crypts: an in situ study. Gastroenterology 1999;117:1363–1369.

    Article  PubMed  CAS  Google Scholar 

  30. Briejer MR, Schuurkes JA, Sarna SK. Idiopathic constipation: too few stools and too little knowledge. Trends Pharmacol Sci 1999;20:1–3.

    Article  PubMed  CAS  Google Scholar 

  31. Basotti G, Gaburri M, Imbimbo B, et al. Colonic mass movements in idiopathic chronic constipation. Gut 1988;29:1173–1179.

    Google Scholar 

  32. Grider JR, Foxx-Orenstein AE, Jin J-G. 5-Hydroxytryptamine4 receptor agonists initiate the peristaltic reflex in human, rat and guinea pig intestine. Gastroenterology 1998;115:370–380.

    Article  PubMed  CAS  Google Scholar 

  33. Briejer MR, Prins NH, Schuurkes JA. Effects of the enterokinetic prucalopride (R093877) on colonic motility in fasted dogs. Neurogastroenterol Motil 2001;13:465–472.

    Article  PubMed  CAS  Google Scholar 

  34. Emmanuel AV, Kamm MA, Roy AJ, Antonelli K. Effect of a novel prokinetic drug, R093877, on gastrointestinal transit in healthy volunteers. Gut 1998;42:511–516.

    Article  PubMed  CAS  Google Scholar 

  35. Briejer MR, Meulemens AL, Bosmans J-P, Van Daele P, Schuurkes JA. In vitro pharmacology of the novel enterokinetic, R093877. Gastroenterology 1997;112:A705 (abstract).

    Google Scholar 

  36. Muller-Lissner SA. Treatment of chronic constipation with cisapride and placebo. Gut 1987;28:1033–1038.

    PubMed  CAS  Google Scholar 

  37. Camillieri M. Review article: Tegaserod. Aliment Pharmacol Ther 2001;15:777–789.

    Google Scholar 

  38. Emmanuel AV, Roy AJ, Nicholls TJ, Kamm M.A. Prucalopride, a systemic enterokinetic, for the treatment of constipation. Aliment Pharmacol Ther 2002;16:1347–1356.

    Article  PubMed  CAS  Google Scholar 

  39. Sloots CEJ, Poen AC, Kerstens R, et al. Effects of prucalopride on colonic transit, anorectal function and bowel habits in patients with chronic constipation. Aliment Pharmacol Ther 2002;16:759–767.

    Article  PubMed  CAS  Google Scholar 

  40. Coremans G, Kerstens R, De Pauw M, Stevens M. Prucalopride is effective in patients with severe chronic constipation in whom laxatives fail to provide adequate relief. Digestion 2003;67:82–89.

    Article  PubMed  CAS  Google Scholar 

  41. Imanishi N, Iwaoka K, Koshio H, et al. New thiazole derivatives as potent and selective 5-hydroxytriptamine 3 (5-HT3) receptor agonists for the treatment of constipation. Bioorg Med Chem 2003:11:1493–1502.

    Article  PubMed  CAS  Google Scholar 

  42. Talley NJ, Phillips SF, Haddad A, et al. GR 38032F (ondansetron), a selective 5HT3 receptor antagonist, slows colonic transit in healthy man. Dig Dis Sci 1990;35:477–480.

    Article  PubMed  CAS  Google Scholar 

  43. Camillieri M, Mayer EA, Drossman DA, et al. Improvement in pain and bowel function in female irritable bowel patients with alosetron, a 5-HT3 receptor antagonist. Aliment Pharmacol Ther 1999;13:1149–1159.

    Article  Google Scholar 

  44. Verne GN, Davis RH, Robinson ME, et al. Treatment of chronic constipation with colchicine: randomized, double-blind, placebo-controlled, crossover trial. Am J Gastroenterol 2003;98:1112–1116.

    PubMed  CAS  Google Scholar 

  45. Parkman HP, Rao SS, Reynolds JC, et al. Neurotrophin-3 improves functional constipation. Am J Gastroenterol 2003;98:1338–1347.

    Article  PubMed  CAS  Google Scholar 

  46. Frame PS, Dolan P, Kohli R, et al. Use of colchicine to treat severe constipation in developmentally disabled patients. J Am Board Fam Pract 1998;11:341–346.

    PubMed  CAS  Google Scholar 

  47. Levy M, Spino M, Read SE. Colchicine: a state of the art review. Pharmacotherapy 1991;11:196–211.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK

    Thanesan Ramalingam BSc, FRCS & Neil J. Mortensen MB ChB, MD, FRCS

Authors
  1. Thanesan Ramalingam BSc, FRCS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Neil J. Mortensen MB ChB, MD, FRCS
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  2. Ohio State University Health Sciences Center at the Cleveland Clinic Foundation, Columbus, OH, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  3. University of South Florida College of Medicine, Tampa, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  4. Charles E. Schmitt College of Science, Florida Atlantic University, Boca Raton, FL, USA

    Steven D. Wexner MD, FACS, FRCS, FRCS (Ed) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery) (21st Century Oncology Chair in Colorectal Surgery Chairman, Department of Colorectal Surgery Chief of Staff, Professor of Surgery and Clinical Professor of Surgery)

  5. University of Hull, Cattingham, UK

    Graeme S. Duthie MD, FRCS, FRCSEd (Reader in Surgery and Honorary Consultant Colorectal Surgeon) (Reader in Surgery and Honorary Consultant Colorectal Surgeon)

  6. Hull and East Yorkshire NHS Trust, Castle Hill Hospital, Cottingham, UK

    Graeme S. Duthie MD, FRCS, FRCSEd (Reader in Surgery and Honorary Consultant Colorectal Surgeon) (Reader in Surgery and Honorary Consultant Colorectal Surgeon)

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag London Limited

About this chapter

Cite this chapter

Ramalingam, T., Mortensen, N.J. (2006). Botulinum Toxin and Other New Pharmacologic Approaches to Constipation. In: Wexner, S.D., Duthie, G.S. (eds) Constipation. Springer, London. https://doi.org/10.1007/978-1-84628-275-1_16

Download citation

  • DOI: https://doi.org/10.1007/978-1-84628-275-1_16

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-85233-724-7

  • Online ISBN: 978-1-84628-275-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation