title: Botulinum toxin: an endoscopic approach for treating fecal incontinence.
abstract: OBJECTIVE
  Fecal incontinence is a common, distressing condition with limited therapeutic options. Botulinum toxin A (BTX-A) injections have been proposed as a treatment for patients with fecal incontinence. This study aimed to determine the short-term clinical outcomes of BTX-A injections in patients with fecal incontinence of varying etiology.
  
  
  METHODS
  Twenty-six patients with fecal incontinence were enrolled, 17 with their native rectum and 9 with a neo-reservoir following a proctectomy for rectal cancer. BTX-A was endoscopically injected into the rectum/reservoir. Scores for severity (CCS) and quality of life (FIQL) were recorded at baseline and at the 3-month follow-up visit.
  
  
  RESULTS
  The CCS was significantly lower after 3 months (median 15, range 4 - 20 vs. 8, range 1 - 19; P = 0.001). The quality of life improved in three of the four FIQL domains. The improvement was maintained in 11 of 12 patients who received more than one injection because of recurrent symptoms. There was no significant predictive factor for the success of BTX-A injections.
  
  
  CONCLUSIONS
  This preliminary study demonstrated that rectal/reservoir injections are an effective short-term treatment for fecal incontinence.
authors.affiliation: Department of Digestive Physiology, CHU, Rouen, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gourcerol
authors.affiliation: Department of Digestive Physiology, CHU, Rouen, France.
authors.forename: Coralie
authors.initials: C
authors.lastname: Bénard
authors.affiliation: Department of Digestive Physiology, CHU, Rouen, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Melchior
authors.affiliation: Department of Hepatogastroenterology, CHU, Rouen, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Touchais
authors.affiliation: Department of Hepatogastroenterology, CHU, Rouen, France.
authors.forename: Phillipe
authors.initials: P
authors.lastname: Ducrotte
authors.affiliation: Biostatistics unit, CHU, Rouen, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Menard
authors.affiliation: Department of Digestive Surgery, CHU, Rouen, France.
authors.forename: Valerie
authors.initials: V
authors.lastname: Bridoux
authors.affiliation: Department of Digestive Physiology, CHU, Rouen, France.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Leroi
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects; D039021:Colonic Pouches / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005242:Fecal Incontinence / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D005260:Female; D005602:France; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects; D017060:Patient Satisfaction; D011788:Quality of Life; D012007:Rectum / Q000473:pathology; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A