Intra-anal application of L-erythro methoxamine gel increases anal resting pressure in patients with incontinence.

Abstract

This study examined the effects of a single dose of intra-anal L-erythro methoxamine on mean anal resting pressure (MARP) and cardiovascular variables in patients with faecal incontinence. Patients had anorectal physiology tests and ultrasonography before participating. Six patients received 0.3 and 1 per cent gels on separate days, two patients received 0.3 per cent gel, and two patients received 1 per cent gel. MARP, blood pressure, pulse rate and plasma drug concentrations were measured for 6 h after application. Intra-anal 0.3 per cent gel caused a rapid, significant rise in MARP lasting 2 h (P = 0.036). In four of these patients, the response was sufficient to increase MARP to within the normal range at 2 h. Application of 1 per cent gel caused a significant rise in MARP for 4 h after application (P = 0.028). There was a significant decrease in pulse at 2 and 1 h respectively after application of 0.3 and 1 per cent gels. Intra-anal application of L-erythro methoxamine can be used to increase MARP in patients with faecal incontinence. Application of 1 per cent L-erythro methoxamine gel produced a rapid, sustained rise in MARP, which raises the possibility of therapeutic application.