Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency

Read, Maria G.; Read, N. W.; Barber, D C; Duthie, H. L.

doi:10.1007/bf01391374

Cited by 268 publications

(105 citation statements)

References 15 publications

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“…The use of constipating agents in the treatment of FI is a common clinical strategy but loperamide studies have focused on FI patients with chronic diarrhea [19,20].…”

Section: Discussionmentioning

confidence: 99%

Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women – a randomized controlled trial

Sjödahl

Walter

Johansson

et al. 2015

Scandinavian Journal of Gastroenterology

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Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women -a randomized controlled trial, 2015, Scandinavian Journal of Gastroenterology, (50) Material and Methods. Sixty-four consecutive female patients, referred to a tertiary centre for FI were included. The patients were randomized to start with either biofeedback (4-6 months) or medical treatment with loperamide and stool-bulking agents (2 months). Both groups continued with a combination of treatments, i.e. medical treatment was added to biofeedback and vice versa. A two-week prospective bowel symptom diary and anorectal physiology were evaluated at baseline, after single-and combination treatments. There was no significant difference between the two groups at any time point. Conclusions:The combination therapy with biofeedback and medical treatment is effective for symptom relief in FI. The symptom improvement was associated with improved fecal consistency, reduced urgency, and increased rectal sensory thresholds.3

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“…The use of constipating agents in the treatment of FI is a common clinical strategy but loperamide studies have focused on FI patients with chronic diarrhea [19,20].…”

Section: Discussionmentioning

confidence: 99%

Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women – a randomized controlled trial

Sjödahl

Walter

Johansson

et al. 2015

Scandinavian Journal of Gastroenterology

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“…In patients with diarrhea and fecal incontinence, loperamide reduced the episodes of incontinence and increased the compliance of the rectosigmoid tract (34). Functional constipation: Functional constipation (35) may be due to slow colonic transit and/or alteration of the defecatory mechanism.…”

Section: Opioid Treatment Of Functionalmentioning

confidence: 99%

Role of Opioid Ligands in the Irritable Bowel Syndrome

Corazziari

1999

Canadian Journal of Gastroenterology and Hepatology

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E Corazziari. Role of opioid ligands in the irritable bowel syndrome. Can J Gastroenterol 1999;13(Suppl A):71A-75A. Endogenous opioid peptides -enkephalins, beta-endorphin and dynorphins -are located in specific sites of the brain, the spinal cord, the autonomic ganglia and the enteric nervous system. Endogenous opioids participate in the regulation of nervous visceral afference and sensitivity as well as of several visceral motor function induced by the central nervous system and through the enteroenteric and the myoenteric reflexes. Their final effect on gut physiology is the net and harmonically balanced result of their binding to mu, delta and kappa opioid receptor subtypes. Exogenous opioid receptor ligands with different affinities for the opioid receptor subtypes have been effectively used to modify and normalize altered gut functions. The mu receptor agonists -morphine and, to a greater extent, the meperidine congeners diphenoxylate and loperamide -have been shown to slow gastrointestinal transit by their effects on the circular and longitudinal muscle of the intestine. Diphenoxylate and, more efficiently, loperamide, for the lack of any effect on the central nervous system, have been usefully employed in the treatment of diarrhea in irritable bowel syndrome (IBS) patients. Unlike the mu receptor agonists morphine and loperamide, which invariably stimulate colonic motility, trimebutine, which has almost equal affinity for mu, delta and kappa receptors, has no effect on normal colonic activity but reduces the abnormal increase in postprandial motor activity in IBS patients and accelerates slow large bowel transit in constipated patients. Opioid ligands can be usefully employed to normalize altered visceral sensitivity in IBS patients. The kappa receptor agonist fedotozine exerts its antinociceptive effect by acting on peripheral nerve endings of sensory vagal and nonvagal afferent pathways. Fedotozine has been shown to increase the threshold of perception to colonic distension in experimental conditions and to affect favourably symptoms of IBS in clinical trials. Le rôle des ligands des récepteurs des opiacés dans le syndrome du côlon irritable RÉSUMÉ : Les peptides opiacés endogènes, les encéphalines, bêta-endorphines et dynorphines, sont localisés en certains points spécifiques du cerveau, de la moelle épinière, des ganglions autonomes et du système nerveux entérique. Les opiacés endogènes participent à la régulation de l'afférence et de la sensibilité viscérale nerveuse, de même qu'à diverses fonctions motrices viscérales induites par le système nerveux central et par les réflexes entéro-entériques et myo-entériques. Leur effet final sur la physiologie intestinale est l'équilibre harmonieux de leurs liaisons aux sous-types de récepteurs des opiacés mu, delta et kappa. Des ligands des récepteurs des opiacés exogènes présentant des affinités diverses à l'endroit des sous-types de récepteurs des opiacés ont été mis à profit utilement pour modifier et normaliser les anomalies de la fonction intestinale. Le...

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“…Medical management of FI commonly begins with antidiarrheals, such as loperamide, although their use is often limited by the development of constipation [7] . Amitriptyline, a tricyclic antidepressant, is also used for the management of FI, however, with modest efficacy [8] .…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and imaging appearance after injection of an ano-rectal bulking agent

Papafragkakis¹

2014

WJGE

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The use of hyaluronic acid and dextranomer (Solesta, Salix) injection in the anal canal is an emerging modality in the treatment of fecal incontinence. However, little is known regarding the endoscopic and radiological appearance following injection of this ano-rectal bulking agent. We report computed tomography and endoscopic findings after hyaluronic acid/dextranomer injection in the ano-rectal area.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Fecal incontinence; Ano-rectal bulking agent; Hyaluronic acid; Dextranomer Core tip: The use of hyaluronic acid and dextranomer (Solesta, Salix) injection in the ano-rectum is an emerging modality in the treatment of fecal incontinence. Our case discusses the endoscopic and radiological findings after injection of this bulking agent in the ano-rectal area.Papafragkakis H, Changela K, Bhatia T, Ona MA, Malieckal A, Paleti V, Fuksbrumer MS, Anand S. Endoscopic and imaging appearance after injection of an ano-rectal bulking agent. World J Gastrointest Endosc 2014; 6(7): 324-327 Available from: URL:

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Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency

Cited by 268 publications

References 15 publications

Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women – a randomized controlled trial

Combination therapy with biofeedback, loperamide, and stool-bulking agents is effective for the treatment of fecal incontinence in women – a randomized controlled trial

Role of Opioid Ligands in the Irritable Bowel Syndrome

Endoscopic and imaging appearance after injection of an ano-rectal bulking agent

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