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Regression of rectal polyps by indomethacin suppository in familial adenomatous polyposis

Report of two cases

  • Case Report
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: The effect of indomethacin suppository on rectal polyps was evaluated in two patients with familial adenomatous polyposis who had undergone total colectomy and ileoproctostomy. METHODS: Both patients received intrarectal administration of 50 mg of indomethacin suppository once or twice daily to control the rectal remnant polyps. RESULTS: With this treatment, an almost complete regression was achieved within three months, in both patients. Polyps recurred after the interruption of indomethacin treatment in one patient. At the present follow-up of two to three years, no cancer has developed. CONCLUSIONS: Indomethacin suppository treatment was effective in controlling rectal remnant polyps in the two patients with familial adenomatous polyposis. Intraluminal administration of indomethacin in suppository form seems more beneficial since it allows for direct contact of the drug with the lesions and produces a high local concentration of the drug.

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References

  1. Nugent KP, Phillips RK. Rectal cancer risk in older patients with familial adenomatous polyposis and an ileorectal anastomosis: a cause for concern. Br J Surg 1992;79:1204–6.

    PubMed  Google Scholar 

  2. De Cosse JJ, Bülow S, Neale K,et al. Rectal cancer risk in patients treated for familial adenomatous polyposis. Br J Surg 1992;79:1372–5.

    PubMed  Google Scholar 

  3. Narisawa T, Sato M, Sano M,et al. Prevention of colon polyposis and carcinomas by right hemicolectomy and indomethacin in animal model. Cancer 1985;56:1719–24.

    PubMed  Google Scholar 

  4. Reddy BS, Nayini J, Tokumo K, Rigotty J, Zang E, Kelloff G. Chemoprevention of colon carcinogenesis by concurrent administration of piroxicam, a nonsteroidal antiinflammatory drug with D,L,-α-difluoromethylornithine, an ornithine decarboxylase inhibitor, in diet. Cancer Res 1990;50:2562–8.

    PubMed  Google Scholar 

  5. Waddell WR, Loughry RW. Sulindac for polyposis of the colon. J Surg Oncol 1983;24:83–7.

    PubMed  Google Scholar 

  6. Labayle D, Fischer D, Vielh P,et al. Sulindac causes regression of rectal polyps in familial adenomatous polyposis. Gastroenterology 1991;101:635–9.

    PubMed  Google Scholar 

  7. Itoh H, Iida M, Mibu R, Terasaka R, Ohsato K. Local chemotherapy for rectal polyposis: intraluminal administration of 5-fluorouracil for postoperative control of adenomas in the retained rectum in familial polyposis. J Clin Gastroenterol 1989;11:645–9.

    PubMed  Google Scholar 

  8. Nicholls RJ, Springall RG, Gallagher P. Regression of rectal adenomas after colectomy and ileorectal anastomosis for familial adenomatous polyposis. BMJ 1988;296:1707–8.

    Google Scholar 

  9. DeCosse JJ, Adams MB, Condon RE. Familial polyposis. Cancer 1977;39:267–73.

    PubMed  Google Scholar 

  10. Verma AK, Ashendel CL, Boutwell RK. Inhibition by prostaglandin synthesis inhibitors of the induction of epidermal ornithine decarboxylase activity, the accumulation of prostaglandins, and tumor promotion caused by 12-O-tetradecanoylphorbol-13-acetate. Cancer Res 1980;40:308–15.

    PubMed  Google Scholar 

  11. Honn KV, Bockman RS, Marnett LJ. Prostaglandins and cancer: a review of tumor initiation through tumor metastasis. Prostaglandins 1981;21:833–64.

    PubMed  Google Scholar 

  12. Jaffe BM. Prostaglandins and cancer: an update. Prostaglandins 1974;6:453–61.

    PubMed  Google Scholar 

  13. Bennett A, Del Tacca M, Stamford IF, Zebro T. Prostaglandins from tumours of human large bowel. Br J Cancer 1977;35:881–4.

    PubMed  Google Scholar 

  14. Leung KH, Mihich E. Prostaglandin modulation of development of cell-mediated immunity in culture. Nature 1980;288:597–600.

    PubMed  Google Scholar 

  15. Balch CM, Dougherty PA, Cloud GA, Tilden AB. Prostaglandin E2-mediated suppression of cellular immunity in colon cancer patients. Surgery 1984;95:71–7.

    PubMed  Google Scholar 

  16. Fujimoto S, Greene MI, Sehon AH. Regulation of the immune response to tumor antigens. J Immunol 1976;116:791–806.

    PubMed  Google Scholar 

  17. Kubota Y, Sunouchi K, Ono M, Sawada T, Muto T. Local immunity and metastasis of colorectal carcinoma. Dis Colon Rectum 1992;35:645–50.

    PubMed  Google Scholar 

  18. Plescia OJ, Smith AH, Grinwich K. Subversion of immune system by tumor cells and role of prostaglandins. Proc Natl Acad Sci USA 1975;72:1848–51.

    PubMed  Google Scholar 

  19. Rosenstein MM, Pelus LM, Strausser HR. Host-mediated immune suppression in tumor bearing mice: in vitro reversal by indomethacin or removal of adherent cells. Fed Proc 1978;37:1451.

    Google Scholar 

  20. Hucker HB, Zacchei AG, Cox SV, Brodie DA, Cantwell NH. Studies on the absorption, distribution and excretion of indomethacin in various species. J Pharmacol Exp Ther 1966;153:237–49.

    Google Scholar 

  21. Duggan DE, Hare LE, Ditzler CA, Lei BW, Kwan KC. The disposition of sulindac. Clin Pharmacol Ther 1977;21:326–35.

    PubMed  Google Scholar 

  22. Rosenberg L, Palmer JR, Zauber AG, Warshauer ME, Stolley PD, Shapiro S. A hypothesis: nonsteroidal anti-inflammatory drugs reduce the incidence of large-bowel cancer. J Natl Cancer Inst 1991;83: 355–8.

    PubMed  Google Scholar 

  23. Thun MJ, Namboodiri MM, Heath CW Jr. Aspirin use and reduced risk of fatal colon cancer. N Engl J Med 1991;325:1593–6.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery I, University of Occupational and Environmental Health, 1-1, Iseigaoka, Yahatanishi-ku, 807, Kitakyushu, Japan

    Keiji Hirata M.D., Hideaki Itoh M.D. & Keiichi Ohsato M.D.

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  1. Keiji Hirata M.D.
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  2. Hideaki Itoh M.D.
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  3. Keiichi Ohsato M.D.
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Hirata, K., Itoh, H. & Ohsato, K. Regression of rectal polyps by indomethacin suppository in familial adenomatous polyposis. Dis Colon Rectum 37, 943–946 (1994). https://doi.org/10.1007/BF02052603

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  • DOI: https://doi.org/10.1007/BF02052603

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