Are there reports of Botulinum toxin (Botox) injections for pelvic floor disorders causing constipation?

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Last updated: April 14, 2025View editorial policy

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From the Research

There are reports of pelvic floor Botox injections causing constipation, as evidenced by a study from 2015 1 where 28.6% of patients experienced worsening of preexisting constipation.

Pelvic Floor Botox Injections and Constipation

Pelvic floor Botox injections are primarily used to treat conditions like pelvic floor dysfunction, including pelvic floor dyssynergia, where muscles don't coordinate properly during bowel movements. While the treatment typically aims to relieve constipation by relaxing overactive pelvic floor muscles, some patients experience worsening constipation as a side effect.

  • This occurs because Botox may sometimes cause excessive relaxation of muscles needed for proper bowel function or affect adjacent muscles unintentionally.
  • The effect is typically temporary, lasting 3-6 months as the Botox wears off.

Management of Constipation After Pelvic Floor Botox Injections

Patients experiencing constipation after pelvic floor Botox injections should:

  • Maintain adequate hydration
  • Increase fiber intake
  • Stay physically active
  • Consult their healthcare provider who might recommend stool softeners or laxatives during this period

Dosing of Botox for Pelvic Floor Conditions

The dosing of Botox for pelvic floor conditions typically ranges from 100-200 units, with the specific amount depending on the condition being treated and the specific muscles targeted, as seen in a study from 2024 2 where 100 U of botulinum toxin A was used for the treatment of spastic pelvic floor syndrome. However, it's essential to consider the most recent and highest quality study, which in this case is the 2024 study 2, to guide clinical decision-making and minimize the risk of constipation as a side effect.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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