methylcellulose and Fecal-Incontinence

To evaluate the efficacy of methylcellulose (Citrucel) and loperamide (Imodium) in managing fecal incontinence by comparing cure rates with expectant management.. Prospective controlled study.. Urogynecology clinic in a university hospital.. Sixty-nine women with fecal incontinence.. All incontinent women received one heaping tablespoon of methylcellulose twice a day, which was increased to two heaping tablespoons twice a day as needed. If the incontinence persisted after taking the maximum dose of methylcellulose for two weeks, loperamide, one capsule twice a day was added, which was increased to two capsules three times a day as needed. If both fecal urgency and incontinence resolved, the therapy was continued for a three-month treatment period. Women, who declined the proposed treatment and did not undergo any other therapy during the subsequent eight weeks, served as controls. A subject or control was considered cured if she stated that her incontinence was cured, had zero Pescatori incontinence point, resolution of fecal urgency, and her incontinence did not affect her emotional, social, occupational, and physical functions during the three-month treatment or eight-week observation period.. Difference in the cure rate between subjects and controls. Results. Fifty-nine subjects were treated with methylcellulose. Forty (68%) also required loperamide. Ten women served as controls. Women treated with methylcellulose and loperamide had a higher cure rate than those managed expectantly (46% vs. 0%, p<0.01).. Methylcellulose and loperamide are an effective treatment for fecal incontinence, at least on a short-term basis.

Topics: Administration, Oral; Analysis of Variance; Antidiarrheals; Fecal Incontinence; Female; Humans; Loperamide; Methylcellulose; Middle Aged; Prospective Studies; Treatment Outcome

Bowel disturbances have been identified as the most important risk factor for fecal incontinence (FI). However, few studies have evaluated the impact of fiber supplementation. Our aim was to assess the correlation between the improvement in stool consistency by fiber supplementation and the changes in urgency and number of FI episodes and in the QoL of patients with FI.. Eighty-three patients who came to our institution with FI and/or fecal urgency associated with loose stools or diarrhea were prospectively included in the study The intervention included dietary advice and methylcellulose 500 mg every 8 h for 6 weeks. All assessments were carried out at baseline and 6 weeks after the start of the intervention, and included a Bristol Stool Scale, a 3-week bowel diary, the St Mark's score, the Fecal Incontinence Quality of Life scale (FIQL) and a bowel satisfaction score.. Sixty-one patients completed the study. At baseline 50 reported episodes of urge incontinence, while 11 did not report FI episodes because they rarely left home to avoid leakage. The Bristol score improved to normal stools in 65.6% of patients after treatment. Bowel diaries showed a statistically significant reduction in the number of bowel movements, urge episodes, urge fecal incontinence episodes and soiling per week. The St Mark's score and the bowel satisfaction score significantly improved after methylcellulose and overall deferment time also increased. FIQL significantly improved in two subdomains (lifestyle, coping/behavior). Thirty-one patients (51.7%) were discharged with methylcellulose as the only treatment.. FI may significantly improve with methylcellulose in selected cases. Assessment of fecal consistency and initial treatment with methylcellulose could be started at primary care level to reduce the need for specialist referral.

Topics: Adult; Aged; Aged, 80 and over; Conservative Treatment; Defecation; Diarrhea; Diet; Dietary Fiber; Dietary Supplements; Directive Counseling; Fecal Incontinence; Feces; Female; Humans; Male; Methylcellulose; Middle Aged; Prospective Studies; Quality of Health Care; Severity of Illness Index; Young Adult

Topics: Child; Child, Preschool; Fecal Incontinence; Humans; Male; Methylcellulose; Senna Extract