www.theage.com.au/articles/2004/05/05/1083635179167.html

Blow it out your butt

Using surgery, creams and injections, scientists are now able to manipulate the pressure of the anus so skillfully they can almost play it like a wind instrument.

British researchers are researching new creams devised by Australian scientists to raise and lower the pressure of the anus, UK colorectal surgeon Professor Robin Phillips told an international surgeons' conference in Melbourne today.

The creams, to be marketed as Incostop and Anoheal, prevent faecal incontinence and constipation-related damage to the anus respectively.

"The muscles in the anus are relaxed at rest, but if it's painful it contracts and goes into spasm, then the anal pressure goes up and you get chronic constipation with hard stool that can cause an anal fissure, which causes more pain and it becomes a self-perpetuating cycle," Prof Phillips explained.

"So you need to reduce the resting anal pressure and we can do that through surgery, through injections of botox, or through this new cream.
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"The results have now become so predictable we joke we can just about play the bottom like a wind instrument."

Botox relaxes the muscles around the anal sphincter - just as it relaxes muscles in the face when used cosmetically - and surgery works by snipping open part of the muscle so it cannot contract as effectively.

However, Prof Phillips said that can swing some patients into the other end of the anal pressure spectrum, fecal incontinence.

"About 10 per cent of the population have problems with bowel continence, which can be just enough to cause an itchy anus, enough to cause skid-marks in the underwear or hard fecal incontinence at the worst end," he said.

"If you slightly increase the pressure in the anus that will seal it better so it stops the problem."

Most preparations currently available from the pharmacy to treat haemorrhoids or other anal disorders were ineffective, Prof Phillips said.

"They're pretty much placebos, they don't really work," he said.

"These two new ones have been proven in trials to be much more effective."

The creams, which were developed by an Australian surgical researcher and are being trialled in the United Kingdom, are expected to be available for prescription in two to three years.

"I think people would much prefer to put on a cream than get an injection or surgery, but surgery is still going to be necessary in a certain number of cases," Prof Phillips said.

Fast foreward 30 seconds into the future:

This stuff has now surpassed crack, meth, and grass combined on the elicit drug market in San Francisco.