BOTULINUM TOXIN IN THE TREATMENT OF CHRONIC CONSTIPATION IN PARKINSONS-DISEASE

Constipation and defaecatory dysfunction occur approximately five time s more frequently in patients with Parkinson's disease than in those w ithout. Ineffective defaecation in Parkinson's disease has been correl ated with failure of relaxation or with paradoxical contraction of the puborectalis muscle during straining. This contraction has been treat ed by surgical division of the muscle, a therapy that has often been u nsuccessful and is accompanied by a prohibitively high rate of inconti nence. We investigated the efficacy of botulinum toxin A injections in treating Parkinsonian patients with severe constipation due to outlet obstruction (puborectalis syndrome).