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Botox Eases Hemorrhoid Surgery Pain

Prevents Muscle Spasms Without Causing Incontinence

WebMD Health News
Reviewed by Gary D. Vogin, MD

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June 3, 2002 -- The same Botox injections that are all the rage for erasing wrinkles may also help ease the pain of another embarrassing problem -- hemorrhoids. A new study shows that Botox can relieve postoperative pain for patients who have their hemorrhoids removed through a surgical procedure known as a hemorrhoidectomy.

Researchers presented their findings today at the American Society of Colon and Rectal Surgeons Annual Meeting in Chicago.

Botox is a purified form of the bacterial poison that causes botulism. The study found that patients injected with Botox had significantly less pain one week after their surgery than a group of patients that received a placebo.

Researchers say pain after hemorrhoid surgery is primarily caused by spasms in the internal sphincter muscle. Surgeons usually attempt to prevent this type of pain by performing a surgical procedure that relaxes the sphincter. But this procedure can cause fecal incontinence.

Study author Justin Davies, MD, of York District Hospital in York, England, and colleagues say they wanted to see if relaxing the muscles with a chemical like Botox would produce the same pain-reducing effect without unwanted side effects.

Botox was recently approved by the FDA to reduce the appearance of wrinkles and has also been approved to treat eye muscle disorders and a nerve disorder that causes pain in the shoulder and neck. Botox injections work by blocking the release of a chemical called acetylcholine, which normally causes the muscles to contract. As a result, the injection temporarily paralyzes or weakens the affected muscles.

The study involved 50 patients who had a standard hemorrhoidectomy. Researchers gave the patients either 0.4 mL of Botox or 0.4 mL of saline injected into the internal sphincter and tracked their pain levels and morphine use for seven days after surgery.

Patients who received Botox used less morphine during the first 24 hours after surgery than the other group (16 mg compared with 22 mg) and reported feeling less pain throughout the study period. Researchers say there were no complications in either group.

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