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

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Abstract

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 complaing 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.

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Authors and Affiliations

  1. Departments of Surgery, Medical Physics and Physiology, Royal Hallamshire Hospital, Sheffield, England

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

Authors
  1. Maria Read
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  2. N. W. Read
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  3. D. C. Barber
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  4. H. L. Duthie
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Additional information

This work was supported by grant no. 252 from the Special Trustees of the Former United Sheffield Hospitals, and by Janssen Pharmaceutica, Beerse, Belgium.

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Read, M., Read, N.W., Barber, D.C. et al. Effects of loperamide on anal sphincter function in patients complaining of chronic diarrhea with fecal incontinence and urgency. Digest Dis Sci 27, 807–814 (1982). https://doi.org/10.1007/BF01391374

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  • DOI: https://doi.org/10.1007/BF01391374

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