[Ergotamine-induced rectal lesions in asymptomatic patients]

Suppositories containing ergotamine can cause anorectal lesions and even fistulae. We therefore carried out prospective investigations on 20 patients (17 female, 3 male) who had been prescribed ergotamine suppositories for migraine therapy. No serious ulceration was found. There was one case of reduced local blood circulation and three patients showed signs of increased blood circulation in the anterior rectal wall. In two further cases we found local hyperemia with minor bleeding. In our opinion anorectal ergotism is a possible, although rare consequence of ergotamine suppository abuse. For longterm treatment alternative routes of ergotamine administration or other groups of substances should therefore be used.