Constipation is one of the most common bowel problems, affecting a great many people at some point in our lifetimes.

It can usually be self-managed at home with medicines like laxatives, but sometimes the problem can be severe enough to warrant further treatment. The mainstay of this treatment is called ‘biofeedback’, where a therapist helps patients to retrain their muscles that control bowel movements.

Investigating a new method of treatment

When biofeedback fails, botox injections into these muscles are an option for treatment. This is an invasive procedure that currently needs to be performed under heavy sedation or a general anaesthetic.

Bowel Research UK funded researchers at Barts Health NHS Trust are trialling a new method for delivering these injections, targeting the key muscle (puborectalis) using ultrasound scanning. It can be done as an outpatient procedure, and the team believe allows for a cleaner, more accurate injection without the need for anaesthetic.

If their work proves the procedure is safe, feasible and acceptable to patients then a full trial can be conducted – allowing for the rollout of a new treatment option that is less invasive for patients and less costly to the NHS.

The research team

The team delivering this work are based at the National Bowel Research Centre, Blizard Institute, as well as at Barts Health NHS Trust. This provides an opportunity for multidisciplinary clinical research that allows innovation to improve patient care. Their tertiary pelvic floor service provides guidance and recommendations on treatment plans for patients across London, Kent, and Surrey (total reference population of 6 million).