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International Journal of Colorectal Disease

, Volume 23, Issue 2, pp 189–194 | Cite as

Cholestyramine—a useful adjunct for the treatment of patients with fecal incontinence

  • Jose M. Remes-Troche
  • Ramazan Ozturk
  • Carrie Philips
  • Mary Stessman
  • Satish S. C. Rao
Original Article

Abstract

Aim/Background

Cholestyramine may improve fecal incontinence, but its use has not been assessed. We report our experience with the use of cholestyramine in the treatment of fecal incontinence.

Materials and methods

Twenty-one patients (19 female, mean age 65 years) with fecal incontinence (≥1 episode/week) received cholestyramine along with biofeedback therapy (group A). Stool frequency, stool consistency (Bristol scale), number of incontinent episodes, satisfaction with bowel function (VAS), and anorectal physiology were assessed at 3 months and at 1 year after treatment. Data were compared with a matched group of 21 incontinent subjects (19 female, mean age 64 years) who received biofeedback alone (group B).

Results

At 3 months and at 1 year, group A patients showed decreased stool frequency (p < 0.01), stool consistency (p = 0.001), and number of incontinent episodes (p < 0.04). In contrast, stool frequency (p = 0.8) and stool consistency (0.23) were not different from baseline in group B subjects. In both groups, there was improvement in the satisfaction with bowel function (p < 0.05), anal sphincter pressures (p < 0.05) and ability to retain saline infusion (p < 0.05). Mean dose of cholestyramine used was 3.6 g; 13 subjects (62%) required dose titration, and 7 (33%) subjects reported minor side effects.

Conclusion

Cholestyramine is safe and useful adjunct for the treatment of diarrhea and fecal incontinence. Most patients require small doses, and dose titration is important. The improvement in stool characteristics favors a drug effect, over and above the benefits of biofeedback therapy.

Keywords

Fecal incontinence Cholestyramine Diarrhea Medical treatment 

Notes

Acknowledgments

We sincerely acknowledge the excellent secretarial assistance of Mrs. Heidi Vekemans.

Grant Support

Dr. Remes-Troche was supported by the AGA, Jon I. Isenberg International Scholar Award; Dr Ozturk was supported by a grant from Department of Health, Turkish Air Force, Ankara; and Dr Rao was supported in part by grant R01DK57100-03 National Institutes of Health.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Jose M. Remes-Troche
    • 1
  • Ramazan Ozturk
    • 1
  • Carrie Philips
    • 1
  • Mary Stessman
    • 1
  • Satish S. C. Rao
    • 1
    • 2
  1. 1.Section of Neurogastroenterology, Division of Gastroenterology-Hepatology, Department of Internal MedicineUniversity of Iowa Carver College of MedicineIowa CityUSA
  2. 2.University of Iowa Hospital & ClinicsIowa CityUSA

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