piperidines and Fecal-Incontinence

We have investigated the effect of loperamide (4 mg tds) on the continence to a standard volume of rectally infused saline and anorectal manometry in 26 patients complaining of chronic diarrhea complicated by fecal incontinence and severe urgency. Each patient was treated for one week with loperamide (4 mg tds) and for one week with an identical placebo in a double-blind cross-over trial. Our results showed that as well as its established effects of improving stool consistency and reducing stool weight, frequency and episodes of incontinence and severe urgency, loperamide also significantly improved continence to a standard volume of rectally infused saline. This action was associated with an increase in the maximum basal sphincter pressure, an increase in the rectal volume required to abolish recovery of the rectoanal inhibitory reflex, and a reduction in rectal compliance. These results suggest that loperamide may have a specific action on the anal sphincter, which may aid continence in patients who complain of diarrhea and fecal incontinence.

Topics: Adult; Aged; Anal Canal; Diarrhea; Fecal Incontinence; Female; Humans; Loperamide; Male; Manometry; Middle Aged; Piperidines; Rectum

The effects of oral loperamide, in doses of 2-6 mg per day, on the stool consistency, daily number of bowel movements and general inconvenience was investigated in seven children and juveniles suffering from incontinence and abnormal bowel habits due to congenital abnormalities. The study was conducted as a double-blind, cross-over analysis. According to the data collected loperamide essentially improves the quality of life of these patients.

Topics: Adolescent; Child; Child, Preschool; Diarrhea; Dose-Response Relationship, Drug; Double-Blind Method; Fecal Incontinence; Female; Humans; Loperamide; Male; Piperidines; Postoperative Complications

The author used Imodium in a clinical trial for the treatment of urinary incontinence following radical prostatectomies, urinary and faecal incontinence due to carcinoma or cerebral accident in history. The drug significantly improved incontinence and did not cause adverse effects. On the basis of the similarity of innervation the author opines that loperamide also influences the function of detrusor and/or bladder orifice besides exerting an antiperistaltic and anal sphincter influencing action.

Topics: Aged; Fecal Incontinence; Female; Humans; Hungary; Loperamide; Male; Middle Aged; Piperidines; Urinary Incontinence

The effect of loperamide on faecal control after Stephens rectoplasty for high imperforate anus was studied in eight patients more than 8 years after surgery. Clinical assessment and anorectal manometry were performed before and after administration of loperamide for 6 to 8 weeks. Decreased faecal soiling was noted in seven of the eight cases. Obstipation forced two patients to stop the medication. The improved faecal control was verified by an increase in squeeze pressure at anorectal manometry in four patients. When incontinence persists after Stephens rectoplasty, loperamide can improve the faecal control in some cases.

Topics: Adolescent; Anal Canal; Anus, Imperforate; Child; Fecal Incontinence; Follow-Up Studies; Humans; Loperamide; Manometry; Piperidines; Postoperative Complications; Pressure; Rectum

Topics: Child; Fecal Incontinence; Female; Gastrointestinal Motility; Humans; Infant; Intestine, Small; Loperamide; Lumbosacral Plexus; Megacolon; Peristalsis; Piperidines; Rectum; Spina Bifida Occulta

Topics: Antipsychotic Agents; Fecal Incontinence; Humans; Intellectual Disability; Middle Aged; Phenothiazines; Piperidines; Schizophrenia; Urinary Incontinence