Abstract
PURPOSE: Ergotamine tartrate suppositories are used for treatment of migraine headache attacks. Chronic abuse may lead to severe anorectal complications such as ulceration, stricture, and rectovaginal fistula. These complications are rare, and only sporadic reports may be found. Nevertheless, awareness of this entity on the part of prescribing physicians and treating colorectal surgeons is essential for a successful outcome, because withdrawal of this medication is an inherent part of treatment. PATIENTS: Five female patients were referred for treatment of symptomatic strictures of the anal canal and lower rectum. All of these patients admitted prolonged, nearly daily use of three to seven ergotamine tartrate suppositories. RESULTS: Three patients with severe stenosis of the anal verge and anal canal were treated by Y-V anoplasty, and two patients with circular stricture of the lower third of the rectum had balloon dilatations. In all patients the use of ergotamine suppositories was stopped, and alternative medication was instituted. Long-term follow-up (3–12 years) showed complete resolution of symptoms. CONCLUSION: In view of the availability of new effective drugs for treatment of migraine headache (serotonin agonists) and considering the potentially severe complications of chronic use of ergotamine, the use of this medication should be abandoned.
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References
VF Eckardt G Kanzler W Remmel (1986) ArticleTitleAnorectal ergotism Gastroenterology 91 1123–1127
P Lamesch R Raab HJ Meyer (1995) ArticleTitleErgotamine-induced anorectal lesions Chirurg 66 826–828
WH Jost F Raulf H Muller-Lobeck (1991) ArticleTitleAnorectal ergotism. Induced by migraine therapy Acta Neurol Scand 84 73–74
J Pfeifer P Reissman SD Wexner (1995) ArticleTitleErgotamine induced complex rectovaginal fistula Dis Colon Rectum 38 1224–1226
J Sayfan Y Adam B Sigal (1977) ArticleTitleErgot induced small bowel perforations Harefuah 93 7–8
GD Garcia JM Goff SuffixJr NC Hadro SD O’Donnel PS Greatorex (2000) ArticleTitleChronic ergot toxicity. A rare cause of lower extremity ischemia J Vasc Surg 31 1245–1247
A Woolf (2000) ArticleTitleWitchcraft or mycotoxin? The Salem witch trials J Toxicol Clin Toxicol 38 457–460
InstitutionalAuthorName. (1998) ArticleTitleManaging migraine Drug Ther Bull 36 41–44
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Sayfan, J. Ergotamine-Induced Anorectal Strictures. Dis Colon Rectum 45, 271–272 (2002). https://doi.org/10.1007/s10350-004-6160-x
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DOI: https://doi.org/10.1007/s10350-004-6160-x