Effects of Loperamide Oxide on Gastrointestinal Transit Time and Anorectal Function in Patients with Chronic Diarrhoea and Faecal Incontinence

Background: Loperamide improves anorectal function in patients with chronic diarrhoea. We wished to investigate whether the prodrug loperamide oxide has similar effects. Methods: Eleven patients with chronic diarrhoea and faecal incontinence participated in a randomized, placebo-controlled, double-b...

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Bibliographic Details
Published in:Scandinavian journal of gastroenterology 1997, Vol.32 (1), p.34-38
Main Authors: Sun, W. M., Read, N. W., Verlinden, M.
Format: Article
Language:English
Subjects:
Adult
Aged
Anal Canal - drug effects
Anal Canal - physiology
Anorectal function
Biological and medical sciences
Chronic Disease
Cross-Over Studies
Diarrhea - drug therapy
Diarrhea - physiopathology
diarrhoea
Digestive system
Double-Blind Method
faecal incontinence
Fecal Incontinence - drug therapy
Fecal Incontinence - physiopathology
Female
Gastrointestinal Transit - drug effects
Humans
Loperamide - adverse effects
Loperamide - analogs & derivatives
Loperamide - pharmacology
Loperamide - therapeutic use
loperamide oxide
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Pressure
Rectum - drug effects
Rectum - physiology
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Summary:Background: Loperamide improves anorectal function in patients with chronic diarrhoea. We wished to investigate whether the prodrug loperamide oxide has similar effects. Methods: Eleven patients with chronic diarrhoea and faecal incontinence participated in a randomized, placebo-controlled, double-blind, crossover study of the effects of loperamide oxide (4 mg twice daily for 1 week). Results: Loperamide oxide reduced wet stool weight and improved the patients' ratings of symptoms. Mouth-to-caecum transit time was not altered, but whole-gut transit time was prolonged. There were limited effects on anorectal function, but the mean minimum basal pressure mainly contributed by the internal anal sphincter (IAS) was increased, as was the mean volume infused before leakage occurred in the saline continence test. Conclusion: Loperamide oxide is effective in the treatment of diarrhoea with faecal incontinence; normalization of colon transit time and an increase in the tone of the IAS seem to be the main determinants of efficacy.
ISSN:0036-5521
1502-7708
DOI:10.3109/00365529709025060