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Randomized controlled trial of topical phenylephrine in the treatment of faecal incontinence
Background: Anal incontinence due to internal sphincter dysfunction is not amenable to simple surgical repair. The α‐adrenergic agonist phenylephrine produces contraction of the internal sphincter and raises resting pressure when applied topically in healthy volunteers. The effect of topical phenyle...
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| Published in: | British journal of surgery 2000-01, Vol.87 (1), p.38-42 |
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| Language: | English |
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| container_title | British journal of surgery |
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| creator | Carapeti, E. A. Kamm, M. A. Phillips, R. K. S. |
| description | Background:
Anal incontinence due to internal sphincter dysfunction is not amenable to simple surgical repair. The α‐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. © 2000 British Journal of Surgery Society Ltd |
| doi_str_mv | 10.1046/j.1365-2168.2000.01306.x |
| format | article |
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Anal incontinence due to internal sphincter dysfunction is not amenable to simple surgical repair. The α‐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. © 2000 British Journal of Surgery Society Ltd</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1046/j.1365-2168.2000.01306.x</identifier><identifier>PMID: 10606908</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Administration, Topical ; Adrenergic alpha-Agonists - administration & dosage ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Catecholaminergic system ; Cross-Over Studies ; Double-Blind Method ; Fecal Incontinence - drug therapy ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Neuropharmacology ; Neurotransmitters. Neurotransmission. Receptors ; Pharmacology. Drug treatments ; Phenylephrine - administration & dosage ; Treatment Outcome</subject><ispartof>British journal of surgery, 2000-01, Vol.87 (1), p.38-42</ispartof><rights>2000 British Journal of Surgery Society Ltd</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3823-8ea11b25e2b66e547057183f3f08a0aa2c7d3ab7f5cd1d48c0af5a2c9fe008003</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4014,27914,27915,27916</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1232152$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10606908$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carapeti, E. A.</creatorcontrib><creatorcontrib>Kamm, M. A.</creatorcontrib><creatorcontrib>Phillips, R. K. S.</creatorcontrib><title>Randomized controlled trial of topical phenylephrine in the treatment of faecal incontinence</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Anal incontinence due to internal sphincter dysfunction is not amenable to simple surgical repair. The α‐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. © 2000 British Journal of Surgery Society Ltd</description><subject>Administration, Topical</subject><subject>Adrenergic alpha-Agonists - administration & dosage</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Catecholaminergic system</subject><subject>Cross-Over Studies</subject><subject>Double-Blind Method</subject><subject>Fecal Incontinence - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Neurotransmitters. Neurotransmission. Receptors</subject><subject>Pharmacology. Drug treatments</subject><subject>Phenylephrine - administration & dosage</subject><subject>Treatment Outcome</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNpN0d9v0zAQB3ALgVjp-BdQHhBvyc527GQSL1CNsrKNafySEJLlOmfVJXFCnGrt_vo5axk8-eT73En2l5CEQkYhlyfrjHIpUkZlmTEAyIBykNn2CZk8Np6SSewUKeWMH5EXIaxhVII9J0cUJMhTKCfk1432Vdu4O6wS0_qhb-s6lkPvdJ20NhnazplYdiv0uxq7Ve88Js4nwwqjQj006IdRWo0jdH5cE5E3eEyeWV0HfHk4p-Tbh7Ovs4_pxef5-ezdRWp4yXhaoqZ0yQSypZQo8gJEQUtuuYVSg9bMFBXXy8IKU9EqLw1oK-LtqUWAEoBPyZv93q5v_2wwDKpxwWBda4_tJqgiKsbyPMJXB7hZNliprneN7nfq739E8PoAdIivsb32xoV_jnFGBYvs7Z7duhp3_61RYzxqrcYU1JiCGuNRD_GorXq_-CJzHsfT_bgLA24fx3X_W8mCF0L9uJqrn5_E9feby4US_B4wY5Kw</recordid><startdate>200001</startdate><enddate>200001</enddate><creator>Carapeti, E. A.</creator><creator>Kamm, M. A.</creator><creator>Phillips, R. K. S.</creator><general>Blackwell Science Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200001</creationdate><title>Randomized controlled trial of topical phenylephrine in the treatment of faecal incontinence</title><author>Carapeti, E. A. ; Kamm, M. A. ; Phillips, R. K. S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3823-8ea11b25e2b66e547057183f3f08a0aa2c7d3ab7f5cd1d48c0af5a2c9fe008003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Administration, Topical</topic><topic>Adrenergic alpha-Agonists - administration & dosage</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Catecholaminergic system</topic><topic>Cross-Over Studies</topic><topic>Double-Blind Method</topic><topic>Fecal Incontinence - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neuropharmacology</topic><topic>Neurotransmitters. Neurotransmission. Receptors</topic><topic>Pharmacology. Drug treatments</topic><topic>Phenylephrine - administration & dosage</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carapeti, E. A.</creatorcontrib><creatorcontrib>Kamm, M. A.</creatorcontrib><creatorcontrib>Phillips, R. K. S.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carapeti, E. A.</au><au>Kamm, M. A.</au><au>Phillips, R. K. S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized controlled trial of topical phenylephrine in the treatment of faecal incontinence</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2000-01</date><risdate>2000</risdate><volume>87</volume><issue>1</issue><spage>38</spage><epage>42</epage><pages>38-42</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Anal incontinence due to internal sphincter dysfunction is not amenable to simple surgical repair. The α‐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. © 2000 British Journal of Surgery Society Ltd</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>10606908</pmid><doi>10.1046/j.1365-2168.2000.01306.x</doi><tpages>5</tpages></addata></record> |
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| ispartof | British journal of surgery, 2000-01, Vol.87 (1), p.38-42 |
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| language | eng |
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| source | Oxford Journals Online |
| subjects | Administration, Topical Adrenergic alpha-Agonists - administration & dosage Adult Aged Aged, 80 and over Biological and medical sciences Catecholaminergic system Cross-Over Studies Double-Blind Method Fecal Incontinence - drug therapy Female Humans Male Medical sciences Middle Aged Neuropharmacology Neurotransmitters. Neurotransmission. Receptors Pharmacology. Drug treatments Phenylephrine - administration & dosage Treatment Outcome |
| title | Randomized controlled trial of topical phenylephrine in the treatment of faecal incontinence |
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