EFFECT OF INDOMETHACIN SUPPOSITORIES ON RECTAL POLYPOSIS IN PATIENTS WITH FAMILIAL ADENOMATOUS POLYPOSIS

BACKGROUND. Oral sulindac is known to reduce polyps in patients with f amilial adenomatous polyposis (FAP). The authors speculated that recta l administration of indomethacin would be effective therapy for adenom as in the rectal remnant of FAP. METHODS. Eight patients with FAP who had been treated by total colectomy with ileorectal anastomosis were a dministered an indomethacin suppository (50 mg) once or twice daily du ring a period of 4 or 8 weeks. The number of polyps at the same site w ithin the rectum was counted under proctoscopy prior to, at the end of , and after the treatment. In four patients, proliferative activity of the rectal mucosa was assessed by immunohistochemical staining for MI B-1. RESULTS. In six of the eight patients who initially had ten or mo re polyps, the number of polyps decreased to fewer than five, whereas such a decrease could not be observed in the remaining two patients. I n the six patients, the number of polyps increased after indomethacin was discontinued. The proliferative activity of the rectal mucosa was higher at the end of treatment than it was prior to indomethacin admin istration. CONCLUSIONS. Indomethacin suppositories may be effective in the management of rectal adenomatosis in patients with FAP. (C) 1996 American Cancer Society.