Digestive Diseases and Sciences

, Volume 50, Issue 9, pp 1576–1583

The Effects of Loperamide on Continence Problems and Anorectal Function in Obese Subjects Taking Orlistat

  • Mark Fox
  • Bernadette Stutz
  • Dieter Menne
  • Michael Fried
  • Werner Schwizer
  • Miriam Thumshirn
Article

Abstract

Continence problems during treatment with orlistat (a lipase inhibitor) are caused when susceptible patients are exposed to increased volumes of loose, fatty stool. Aim: To investigate the dose-response effects of loperamide on continence and anorectal function in subjects susceptible to continence problems on orlistat. Method: Ten obese subjects enterred a randomized controlled, double-blind study of loperamide at placebo, 2, 4, and 6 mg/day in a factorial design. Continence problems during orlistat treatment were self-assessed by patient diary. Anorectal function and continence were assessed by barostat, manometry, and retention testing. Results: Loperamide increased stool consistency with dose (p = 0.07) and this effect reduced continence problems during orlistat treatment (p < 0.05). A bell-shaped dose-response relationship was present with anal sphincter function (p < 0.01) and anorectal sensitivity (p < 0.01). Conclusion: Loperamide has beneficial effects on stool consistency and continence in obese subjects taking orlistat. The effect on stool consistency appeared more important than effects on anorectal function.

Keywords

orlistat loperamide fecal continence anorectal function physiological measurement retention test 

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Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Mark Fox
    • 1
  • Bernadette Stutz
    • 2
  • Dieter Menne
    • 3
  • Michael Fried
    • 2
  • Werner Schwizer
    • 2
  • Miriam Thumshirn
    • 2
  1. 1.Department of GastroenterologySt. Thomas’ HospitalLondonUnited Kingdom
  2. 2.Department of Gastroenterology and HepatologyUniversity Hospital of ZürichZürichSwitzerland
  3. 3.Menne BiomedTübingenGermany

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