Document Detail


Randomized controlled trial of topical phenylephrine in the treatment of faecal incontinence.
MedLine Citation:
PMID:  10606908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Anal incontinence due to internal sphincter dysfunction is not amenable to simple surgical repair. The alpha-adrenergic agonist phenylephrine produces contraction of the internal sphincter and raises resting pressure when applied topically in healthy volunteers. The effect of topical phenylephrine in the treatment of faecal incontinence due to internal sphincter dysfunction was investigated. METHODS: Thirty-six patients (22 women) aged 28-81 (mean 58) years with faecal incontinence and ultrasonographically structurally normal anal sphincter muscles were treated with topical 10 per cent phenylephrine and placebo gels, allocated in random order in a double-blind crossover study. Maximum resting anal sphincter pressure and anodermal blood flow were measured. A symptom questionnaire was completed and incontinence score determined using a validated scale. RESULTS: There were no significant differences in incontinence score, resting anal pressure and anodermal blood flow between the active and placebo treatments. Six patients on active treatment and two on placebo experienced more than 75 per cent subjective improvement. Three patients developed allergic dermatitis to phenylephrine. CONCLUSION: This is the first study of the use of a topical pharmacological agent to treat faecal incontinence. This concentration of topical phenylephrine did not produce a significant improvement in symptoms or function. A subgroup of patients may respond. Further studies are required with increased concentrations.
Authors:
E A Carapeti; M A Kamm; R K Phillips
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  87     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-03     Completed Date:  2000-02-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  38-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Physiology, St. Mark's Hospital, Harrow, UK.
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Adrenergic alpha-Agonists / administration & dosage*
Adult
Aged
Aged, 80 and over
Cross-Over Studies
Double-Blind Method
Fecal Incontinence / drug therapy*
Female
Humans
Male
Middle Aged
Phenylephrine / administration & dosage*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 59-42-7/Phenylephrine
Comments/Corrections
Comment In:
Br J Surg. 2000 Jul;87(7):965-6   [PMID:  10931036 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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