Drug treatment for faecal incontinence in adults

Current and Emerging Treatment Options for Fecal Incontinence

“…Dietary modification, such as avoiding caffeine, citrus fruits, spicy foods, alcohol, and dairy products (in patients with lactose intolerance) may help, but definitive evidence22 for these restrictions is lacking. Opinions differ as to whether the addition of dietary fiber is beneficial or detrimental for the treatment of FI6,34,35; however, methylcellulose is resistant to fermentation by colonic microflora and may be less likely than some other forms of fiber to exacerbate diarrhea 36…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34.…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34. In 1 clinical trial, the tricyclic antidepressant amitriptyline improved FI scores (scale, 1 to 18) from a median of 16 at baseline to 3 ( P <0.001) after 4 weeks of treatment 37.…”

Current and Emerging Treatment Options for Fecal Incontinence

“…Dietary modification, such as avoiding caffeine, citrus fruits, spicy foods, alcohol, and dairy products (in patients with lactose intolerance) may help, but definitive evidence22 for these restrictions is lacking. Opinions differ as to whether the addition of dietary fiber is beneficial or detrimental for the treatment of FI6,34,35; however, methylcellulose is resistant to fermentation by colonic microflora and may be less likely than some other forms of fiber to exacerbate diarrhea 36…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34.…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34. In 1 clinical trial, the tricyclic antidepressant amitriptyline improved FI scores (scale, 1 to 18) from a median of 16 at baseline to 3 ( P <0.001) after 4 weeks of treatment 37.…”

Characteristics of primary care processes for the treatment of faecal incontinence in an urban area

“…Another finding of the present study is the apparent underuse, in primary care, of simple treatments shown to be effective by improving quality of life in patients with faecal incontinance [15,16]. These treatments include opiates, such as loperamide or, better fibre compounds, which improve faecal consistency and diminish urgency, improving faecal continence [17], and thus, are ideally suited to primary care as a first‐line treatment [15,17]; However, none of the patients interviewed were undergoing treatment with these drugs. It is possible that patients may not remember treatments received in the past, specifically if the medical had been poor.…”

Biofeedback therapy for symptoms of bowel dysfunction following surgery for colorectal cancer

“…Objective measures such as anorectal manometry and endoanal ultrasonography have been found to have major limitations as surrogate measures for FI for reasons such as poor sensitivity and specificity [23,24]. Physiological studies, while helpful in diagnosing the cause of FI and indicating possible treatment options, provide little value as a measurement tool.…”

Current and Emerging Treatment Options for Fecal Incontinence

“…Dietary modification, such as avoiding caffeine, citrus fruits, spicy foods, alcohol, and dairy products (in patients with lactose intolerance) may help, but definitive evidence22 for these restrictions is lacking. Opinions differ as to whether the addition of dietary fiber is beneficial or detrimental for the treatment of FI6,34,35; however, methylcellulose is resistant to fermentation by colonic microflora and may be less likely than some other forms of fiber to exacerbate diarrhea 36…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34.…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34. In 1 clinical trial, the tricyclic antidepressant amitriptyline improved FI scores (scale, 1 to 18) from a median of 16 at baseline to 3 ( P <0.001) after 4 weeks of treatment 37.…”

Characteristics of primary care processes for the treatment of faecal incontinence in an urban area

“…Another finding of the present study is the apparent underuse, in primary care, of simple treatments shown to be effective by improving quality of life in patients with faecal incontinance [15,16]. These treatments include opiates, such as loperamide or, better fibre compounds, which improve faecal consistency and diminish urgency, improving faecal continence [17], and thus, are ideally suited to primary care as a first‐line treatment [15,17]; However, none of the patients interviewed were undergoing treatment with these drugs. It is possible that patients may not remember treatments received in the past, specifically if the medical had been poor.…”

Biofeedback therapy for symptoms of bowel dysfunction following surgery for colorectal cancer

“…Objective measures such as anorectal manometry and endoanal ultrasonography have been found to have major limitations as surrogate measures for FI for reasons such as poor sensitivity and specificity [23,24]. Physiological studies, while helpful in diagnosing the cause of FI and indicating possible treatment options, provide little value as a measurement tool.…”

Current and Emerging Treatment Options for Fecal Incontinence

“…Dietary modification, such as avoiding caffeine, citrus fruits, spicy foods, alcohol, and dairy products (in patients with lactose intolerance) may help, but definitive evidence22 for these restrictions is lacking. Opinions differ as to whether the addition of dietary fiber is beneficial or detrimental for the treatment of FI6,34,35; however, methylcellulose is resistant to fermentation by colonic microflora and may be less likely than some other forms of fiber to exacerbate diarrhea 36…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34.…”

“…Antidiarrheal or antimotility agents, including loperamide or diphenoxylate, may be beneficial in patients with loose stools and urgency 34. Limited evidence suggests that drugs administered to enhance sphincter tone, such as phenylepinephrine and sodium valproate, may be helpful in patients with passive FI and normal anal sphincter function 34. In 1 clinical trial, the tricyclic antidepressant amitriptyline improved FI scores (scale, 1 to 18) from a median of 16 at baseline to 3 ( P <0.001) after 4 weeks of treatment 37.…”

Characteristics of primary care processes for the treatment of faecal incontinence in an urban area

“…Another finding of the present study is the apparent underuse, in primary care, of simple treatments shown to be effective by improving quality of life in patients with faecal incontinance [15,16]. These treatments include opiates, such as loperamide or, better fibre compounds, which improve faecal consistency and diminish urgency, improving faecal continence [17], and thus, are ideally suited to primary care as a first‐line treatment [15,17]; However, none of the patients interviewed were undergoing treatment with these drugs. It is possible that patients may not remember treatments received in the past, specifically if the medical had been poor.…”

Biofeedback therapy for symptoms of bowel dysfunction following surgery for colorectal cancer

“…Objective measures such as anorectal manometry and endoanal ultrasonography have been found to have major limitations as surrogate measures for FI for reasons such as poor sensitivity and specificity [23,24]. Physiological studies, while helpful in diagnosing the cause of FI and indicating possible treatment options, provide little value as a measurement tool.…”