Abstract | BACKGROUND:
Fecal incontinence is a devastating condition with few US Food and Drug Administration-approved pharmacologic treatment options. Loperamide and psyllium, both first-line treatments, have different mechanisms of action without any comparative data. OBJECTIVE: DESIGN: SETTINGS: Our sites included outpatient clinics within a Veterans Affairs medical center and university affiliate. PATIENTS: Participants included community-dwelling adults (n = 80) with at least 1 fecal incontinent episode on a 7-day bowel diary. INTERVENTION: MAIN OUTCOME MEASURES: The primary outcome was the number of fecal incontinence episodes from 7-day bowel diaries. Secondary outcomes included symptom severity, quality of life, and tolerability. RESULTS: Mean age was 60.7 ± 10.1 years; 68% were men. After determining nonsignificant carryover effects, combined analyses showed no differences between the loperamide and psyllium groups for reducing fecal incontinent episodes, symptom severity, or quality of life. Within each group, both loperamide and psyllium reduced fecal incontinent episodes and improved symptom severity and quality of life. Constipation occurred in 29% of participants for loperamide vs 10% for psyllium. LIMITATIONS: Limitations include the washout period length and dropout rate after crossing over to the second intervention. CONCLUSIONS:
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Authors | Alayne D Markland, Kathryn L Burgio, William E Whitehead, Holly E Richter, C Mel Wilcox, David T Redden, Timothy M Beasley, Patricia S Goode |
Journal | Diseases of the colon and rectum
(Dis Colon Rectum)
Vol. 58
Issue 10
Pg. 983-93
(Oct 2015)
ISSN: 1530-0358 [Electronic] United States |
PMID | 26347971
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
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Chemical References |
- Antidiarrheals
- Cathartics
- Loperamide
- Psyllium
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Topics |
- Aged
- Antidiarrheals
(administration & dosage, adverse effects)
- Cathartics
(administration & dosage, adverse effects)
- Constipation
(etiology)
- Double-Blind Method
- Drug Administration Schedule
- Fecal Incontinence
(drug therapy, physiopathology, psychology)
- Female
- Humans
- Loperamide
(administration & dosage, adverse effects)
- Male
- Middle Aged
- Psyllium
(administration & dosage, adverse effects)
- Quality of Life
- Symptom Assessment
- Treatment Outcome
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