Efficacy and Mechanisms of Pharmacologic Treatment of Fecal Incontinence

Efficacy and Mechanisms of Pharmacologic Treatment of Fecal Incontinence

The purpose of this study is to evaluate and compare treatment with fiber and loperamide for fecal incontinence.

Fecal incontinence (FI) affects 4-24% adults in the community and greatly impacts quality of life. Both fiber and loperamide are common, first-line treatments for diarrhea-associated FI in primary care. No known studies exist that compare fiber and loperamide for diarrhea-predominant FI. Further knowledge is needed to define which treatment is more effective and to compare drug tolerability (side effects) for FI. This study will also look at changes in quality of life with treatment and potential mechanisms of drug treatment.

Inclusion Criteria:

• weekly fecal incontinence

Exclusion Criteria:

• fecal impaction
• inability to complete a baseline 1-week bowel diary
• rectal prolapse
• any prior radiation to the pelvis
• colo-rectal cancer
• rectal fistula
• inflammatory bowel disease
• neurological diseases (spinal cord injury, multiple sclerosis, Parkinson's disease)
• constipation (<2 bowel movements/week) or total colectomy