Abstract
The physiological and clinical effects of loperamide treatment versus placebo were investigated in a randomized, double-blind, crossover study in patients operated with restorative proctocolectomy. Sixteen patients operated with endoanal mucosectomy and a handsewn ileal pouch-anal anastomosis and 14 patients operated with abdominal proctocolectomy and stapling of the pouch to the top of the anal canal were studied. While loperamide treatment increased resting anal pressure in both groups of patients by approximately 20% (P<0.05), squeeze pressure was not affected. Loperamide did not affect pouch volume or contractility. Sensory thresholds and the recto/pouch-anal inhibitory reflex were not influenced by loperamide treatment. Clinical function was improved, with a reduced bowel frequency and an improved nighttime continence, with less soiling (P<0.05) as well as need to wear a protective pad.
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This investigation was supported by grants from the Swedish Medical Research Council (17X-03117), the University of Göteborg, Göteborgs Läkarsällskap, Assar Gabrielssons Fond, AB Skandias 100-årsfond and Ingabritt och Arne Lundbergs Forskningsfond.
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Hallgren, T., Fasth, S., Delbro, D.S. et al. Loperamide improves anal sphincter function and continence after restorative proctocolectomy. Digest Dis Sci 39, 2612–2618 (1994). https://doi.org/10.1007/BF02087698
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DOI: https://doi.org/10.1007/BF02087698