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Discussion Starter · #1 ·
I've had chronic constipation for many years. Nothing worked except lots of magnesium to induce diarrhea. Not much of a solution, but it was the best I could do.

Two months ago I had a Botox injection following an ARP (anal-rectal physical) diagnosis of "rectal outlet obstruction due to anal spasm." And it WORKED!!

I'm just writing to tell people about Botox if they don't know. Suddenly I consider anal surgeons to be humanity's greatest benefactors!
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Maybe Botox is old news but I haven't been on this site for a while so I don't know. BTW, my gastroenterologist never mentioned this procedure. I was "lucky" enough to get a hemmorrhoid, and the anal surgeon happened to know about Botox. (Dr. William Cannon Lewis in San Antonio; the procedure is fairly new in the US, but I don't get the impression from him that he's the only one in America who does this procedure or anything.)

If anyone has had any problems with Botox, let me know. But for me, it has been a month since post-op recovery, with no problems. I am free!!!!!!
 

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Honestly, that is great news. I would try it myself but I don't know the first thing about this and it's considered weird for a 17 year old to have Botox in the butt don't you think? But either way if this does work or at least helps I'm down to try it. Can you explain to me how and why this works? Would be great to know, since my doctors told me not to trust anything off the internet :)
 

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That's great news! I've also been diagnosed with various pelvic floor issues- including outlet obstruction even though I tend to the loose end of things- seldom get what I'd consider true constipation. Things actually move through a little too fast but get stuck in the sigmoid/rectal area so I have sometimes difficult and usually incomplete evacuation. I was recommended to do a two-week biofeedback program twice at Mayo but it is not covered by most insurance and the cost is extremely high- currently around $9,000.00+ so I' ve never been able to try it. Based on what I've read from other patients who did it it hasn't been very successful. And Mayo does not seem to offer any other treatments if you can't afford the program or if it doesn't work.

I wouldn't mind trying it although I've heard that it can lead to incontinence in some patients. But there is no way to know without actually trying it. I'd be willing to give it a go if someone would offer it. I'm pretty sure that insurance won't cover it but it certainly would cost less than the biofeedback. Do you know how often you would have to repeat it? Was it painful when you got the injection?
 

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fast transit--so glad this has worked for you! that's wonderful. and may that continue!

i've been reading about botox for anismus for a while. and yes, generally it is considered experimental and not covered by insurance. from what i've read and what people have said, it generally works initially but sometimes repeated injection(s) are needed.

http://www.ncbi.nlm.nih.gov/pubmed/21689279

but it does sound promising. i'm willing to try anything--as long as i can reasonably afford it. would be interested to know what it costs.
 

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Discussion Starter · #5 ·
Duf--What you'd need to do is find an anal surgeon (or gastroenterologist?) who has the equipment to do ARP testing (anal-rectal physical). It's a computer hooked up to electrodes and a little (painless) probe in the anus. This determines if (as I understand it) your anal canal is abnormally long. If it is, then it means that the rectal muscles (?) have to push extra hard to overcome resistance from the anus. Thus: constipation. The Botox numbs some of the extra muscle in the anus, so that it offers less resistance to the stool.

Airplane--I don't know if this condition would cause D. It couldn't hurt to ask your GI or an anal surgeon.

Annie--The ARP diagnostic was painless and took about 10 minutes. The Botox required general anesthesia. There was no pain afterwards, but for 2-3 weeks I was borderline incontinent--but I stupidly was continuing the magnesium regimen I'd been using for years to induce diarrhea! Once I stopped doing that and resumed a normal diet with fiber, it was like a miracle had occurred. I was "normal" again.

Yes, Botox wears off and repeat injections in 3-4 mos. may be needed. That's a great link you posted--thanks! From the link, it sounds like I'll need a repeat procedure next month. We'll see.

It looks like my insurance is covering. The initial notice didn't say they considered it an experimental procedure. If you don't have insurance, my guess is that for a cash customer it would cost roughly what a colonoscopy does: you need to pay the surgeon, an anesthesiologist, and a nurse or two, and it doesn't take long (well under an hour).
 

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fast transit--thanks so much for your information! and oh yes that's GREAT your insurance covers it!!

i do have insurance but unfortunately all i can afford since hubby and i are retired is a tightfisted hmo. right now i'm trying to get them to cover my biofeedback/physical therapy for pfd and anismus. so far insurance tells me they'll cover the initial evaluation and the first visit and they are currently "considering" covers additional visits.

if bio/pt doesn't help me, i'll be looking into botox.

so glad you've found relief. wishing you all the best.
 
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