ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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The Application Of Botulinum Toxin In Gastroenterology: Review
Dr. Zeki YEŞİLOVA,a Dr. M. İlkin NAHARCIb
aGastroenteroloji BD, bDahiliye BD, Gülhane Askeri Tıp Akademisi, ANKARA
Botulinum toxin is a protein produced by the anaerobic bacterium Clostridium botulinum. It is one of the deadliest poisons known, causing death by muscle paralysis. Botulinum toxin was initially used in medicine to produce a potent neuromuscular blockade in spastic neuromuscular conditions (hemifacial spasm, spasmodic torticollis, blepharospasm, neurogenic bladder, limb spasticity). It was later found to interfere with acetylcholine release in the myenteric plexus and inhibit contraction in gastrointestinal smooth muscle, leading to its use in the treatment of various conditions. Botulinum toxin injection is safe and well tolerated. This therapy appears safe, with no serious adverse effects at therapeutic doses. It is a treatment with rather limited benefit duration. Achalasia has been treated pharmacologically, with nitrates or calcium channel blockers, forceful balloon dilation, or surgical myotomy. The results of these treatment regimens were disappointing. Botulinum toxin appears to be the treatment of choice for achalasia in patients who are poor candidates for surgery or pneumatic dilation and in elderly patients with comorbid illnesses associated with reduced life expectancy. In the anal fissure treatment, it has fewer complications than the other methods (anal sphincter dilation, sphincterotomy). For this reason, it seems to be a successful therapeutic option. It has been used successfully in the management of various conditions, including diffuse esophageal spasm, isolated hypertensive lower esophageal sphincter and biliary dyskinesia. Botulinum toxin seems to be a promising agent in gastroenterology. Large controlled trials are needed to establish the role of botulinum toxin and its safety in gastroenterology.Keywords: Botulinum toxins, gastroenterologyTurkiye Klinikleri J Med Sci 2005, 25:835-840
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