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Pharmacotherapy for Fecal Incontinence: A Review

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Diseases of the Colon & Rectum

Fecal incontinence is a common clinical problem that often is frustrating to the patient and treating physician. Nonsurgical management for fecal incontinence includes dietary manipulation, Kegel exercises, perianal skin care, and biofeedback therapy. Pharmacotherapies often are used to assist in management of fecal incontinence. A variety of pharmacotherapies have been utilized for the management of fecal incontinence; limited data from randomized, placebo-controlled trials are available. This is a review of the existing literature on clinical trials of several classes of drugs and other medical therapies that may be beneficial for patients with fecal incontinence. The information in this article was obtained by a MEDLINE search for all clinical trials of drug therapy for fecal incontinence. These treatments and the existing data on their use are summarized. Treatments reviewed include stool bulking agents, with an emphasis on the most promising effect obtained with calcium polycarbophil, constipating agents, including loperamide, codeine, amitriptyline, atropine, and diphenoxylate agents injected into the anal sphincter, drugs to enhance anal sphincter function, including topical phenylepherine and oral sodium valproate, and trials of fecal disimpaction. A new classification to easily remember the treatment categories for this condition, based on the “ABCs of treatment for fecal incontinence,” has been introduced into the structure of this review.

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Authors and Affiliations

  1. Division of Gastroenterology, Rush Medical Center, Chicago, Illinois, USA

    Eli D. Ehrenpreis M.D.

  2. University of Pennsylvania, Philadelphia, Pennsylvania, USA

    David Chang B.A.

  3. Semmelweis University, Budapest, Hungary

    Elad Eichenwald B.S.

  4. Adult Care Specialists, 1538 N. Arlington Heights Road, Arlington Heights, Illinois, 60004, USA

    Eli D. Ehrenpreis M.D.

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  1. Eli D. Ehrenpreis M.D.
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  2. David Chang B.A.
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  3. Elad Eichenwald B.S.
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Correspondence to Eli D. Ehrenpreis M.D..

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Ehrenpreis, E.D., Chang, D. & Eichenwald, E. Pharmacotherapy for Fecal Incontinence: A Review. Dis Colon Rectum 50, 641–649 (2007). https://doi.org/10.1007/s10350-006-0778-9

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