TREATMENT OF PROCTALGIA FUGAX WITH SALBUTAMOL INHALATION

Objectives: Although no generally effective treatment for proctalgia f ugax is known, inhalation of salbutamol has been reported to shorten p ain attacks in isolated cases. Methods: We conducted a randomized, dou ble-blind, placebo-controlled, crossover trial of inhaled salbutamol i n 18 patients with proctalgia fugax. The clinical effect was evaluated by recording the duration of severe pain and discomfort during acute attacks. In addition, anorectal motility recordings were analyzed for possible changes in anal resting tone, sphincter relaxation during rec tal distension and in rectal compliance prior to and following adminis tration of the two test substances. Results: Sixteen patients complete d all investigations. Compared to placebo, salbutamol inhalation short ened the duration of severe pain (p = 0.019). The effect was most mark ed in patients having prolonged attacks. In the asymptomatic state, ne ither salbutamol nor placebo led to a significant change in anal resti ng pressure, anal relaxation during rectal distension, or rectal compl iance. Salbutamol also did not alter the threshold for rectal sensatio n. Conclusions: Salbutamol inhalation shortens attacks of severe pain in patients with proctalgia fugax. The mechanism of this effect remain s unexplained.