Abstract:Objective: to evaluate whether faecal incontinence can be improved by treatment of constipation in elderly patients with faecal incontinence associated with impairment of rectal emptying. Design: a prospective randomized study with a 2-month follow-up. Setting: five long-term care units. Subjects: 206 patients with daily faecal incontinence associated with chronic rectal emptying impairments such as faecal impaction received either a single osmotic laxative (group I) or an osmotic agent along with a rectal sti… Show more
“…In one RCT, 206 frail residents in long-term care facilities who had a history of fecal incontinence and impaction were randomly assigned to receive either lactulose alone or lactulose with a daily glycerine suppository and weekly enemas with tap water. 34 Among the 123 participants remaining in the study after 5 weeks, episodes of incontinence and soiled laundry did not differ significantly between the study arms.…”
“…In one RCT, 206 frail residents in long-term care facilities who had a history of fecal incontinence and impaction were randomly assigned to receive either lactulose alone or lactulose with a daily glycerine suppository and weekly enemas with tap water. 34 Among the 123 participants remaining in the study after 5 weeks, episodes of incontinence and soiled laundry did not differ significantly between the study arms.…”
“…There is evidence for the use of modern medications such as anti-diarrheal medications for diarrheal-associated faecal incontinence [29] and laxatives for constipation-associated faecal incontinence [30]. However, there is currently no evidence on the effectiveness of traditional herbal medicine for faecal incontinence.…”
“…Chassagne et al 49 studied the effect of treatment of constipation and fecal incontinence associated with impairment of rectal emptying in a group of elderly residents in a long-term care facility. Initially, 206 patients were studied.…”
Fecal incontinence is a common clinical problem that often is frustrating to the patient and treating physician. Nonsurgical management for fecal incontinence includes dietary manipulation, Kegel exercises, perianal skin care, and biofeedback therapy. Pharmacotherapies often are used to assist in management of fecal incontinence. A variety of pharmacotherapies have been utilized for the management of fecal incontinence; limited data from randomized, placebo-controlled trials are available. This is a review of the existing literature on clinical trials of several classes of drugs and other medical therapies that may be beneficial for patients with fecal incontinence. The information in this article was obtained by a MEDLINE search for all clinical trials of drug therapy for fecal incontinence. These treatments and the existing data on their use are summarized. Treatments reviewed include stool bulking agents, with an emphasis on the most promising effect obtained with calcium polycarbophil, constipating agents, including loperamide, codeine, amitriptyline, atropine, and diphenoxylate agents injected into the anal sphincter, drugs to enhance anal sphincter function, including topical phenylepherine and oral sodium valproate, and trials of fecal disimpaction. A new classification to easily remember the treatment categories for this condition, based on the "ABCs of treatment for fecal incontinence," has been introduced into the structure of this review.
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