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Digestive Health: Botox -- Not Just For Wrinkles

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Botox -- Not Just For Wrinkles

Botox is best known for its ability to ease facial lines and make a person appear younger. But before the drug went Hollywood, it was originally developed for a less glamorous purpose: treating strabismus (crossed eyes) and blepharospasm (abnormal blinking). Today, Botox is used off-label to treat many conditions, including some digestive disorders.

Botulinum toxin A, from which Botox is derived, is a highly poisonous bacterial toxin that attacks the nerves and causes muscle paralysis. It is one of the world's most dangerous substances. But the same properties that make this toxin deadly in large doses also help relieve muscle spasms when used carefully in very small amounts.

When injected into the affected muscle, Botox prevents release of a neurotransmitter called acetylcholine from the nerve fibers controlling the muscle. As a result, the muscle loses nervous stimulation and relaxes -- faces stop frowning or eyes stop crossing.

Botox offers several advantages over other treatments: Unlike oral drugs, it doesn't enter the bloodstream and typically remains in the affected muscle only, so side effects are rare. Unlike surgery, it is noninvasive, painless, and quick. Its effects typically fade after a few months, but repeat treatments appear to offer the same benefits as the first injection.

Botox for the Digestive Tract -- Several digestive disorders caused by muscle spasms are candidates for Botox treatment. Achalasia was the first to benefit from Botox; now it's used for anal fissures, gastroparesis, constipation, and dysphagia. Although the U.S. Food and Drug Administration (FDA) has not approved Botox for any of these conditions, some insurance companies will cover its use.

Botox for Constipation. One of the common causes of constipation is when the pelvic floor muscles contract too much or don't relax enough during a bowel movement. A November 2006 study in The American Journal of Gastroenterology found that Botox may help correct these muscle problems.

Italian researchers injected Botox into two sites on either side of the puborectalis muscle in 24 people with chronic constipation. Two months later, 19 participants had significant improvement, and the other five experienced symptom relief after a second set of injections. None of the participants experienced any significant side effects, and after an average of three years, all of them remained constipation free.

These results are surprising, given that the effects of Botox injections usually wear off after a few months. Although the study did not include a control group, the results suggest that Botox is a promising treatment that warrants more research.

Digestive Disorders

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