title: Intra-anal application of L-erythro methoxamine gel increases anal resting pressure in patients with incontinence.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Section of Surgery, University Hospital, Queen's Medical Centre, Nottingham, UK. pashanisar@hotmail.com
authors.forename: P J
authors.initials: PJ
authors.lastname: Nisar
authors.forename: H-J
authors.initials: HJ
authors.lastname: Gruss
authors.forename: D
authors.initials: D
authors.lastname: Bush
authors.forename: A G
authors.initials: AG
authors.lastname: Acheson
authors.forename: J H
authors.initials: JH
authors.lastname: Scholefield
mesh_terms: D000285:Administration, Rectal; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000187:drug effects* / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects; D005242:Fecal Incontinence / Q000188:drug therapy*; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008729:Methoxamine / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D011312:Pressure; D011674:Pulse; D016896:Treatment Outcome
chemical_list: D000316:Adrenergic alpha-Agonists; D005782:Gels; D008729:Methoxamine