Literature DB >> 16133954

The effects of loperamide on continence problems and anorectal function in obese subjects taking orlistat.

Mark Fox1, Bernadette Stutz, Dieter Menne, Michael Fried, Werner Schwizer, Miriam Thumshirn.   

Abstract

UNLABELLED: 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.

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Year:  2005        PMID: 16133954     DOI: 10.1007/s10620-005-2900-6

Source DB:  PubMed          Journal:  Dig Dis Sci        ISSN: 0163-2116            Impact factor:   3.199


  21 in total

1.  Standardization of barostat procedures for testing smooth muscle tone and sensory thresholds in the gastrointestinal tract. The Working Team of Glaxo-Wellcome Research, UK.

Authors:  W E Whitehead; M Delvaux
Journal:  Dig Dis Sci       Date:  1997-02       Impact factor: 3.199

2.  In vitro pharmacologic differentiation of sphincteric and non-sphincteric muscle.

Authors:  D D Bass; T J Ustach; M M Schuster
Journal:  Johns Hopkins Med J       Date:  1970-10

3.  The physical properties of rectal contents have effects on anorectal continence: insights from a study into the cause of fecal spotting on orlistat.

Authors:  Mark Fox; Werner Schwizer; Dieter Menne; Bernadette Stutz; Michael Fried; Miriam Thumshirn
Journal:  Dis Colon Rectum       Date:  2004-12       Impact factor: 4.585

4.  Loperamide-simethicone vs loperamide alone, simethicone alone, and placebo in the treatment of acute diarrhea with gas-related abdominal discomfort. A randomized controlled trial.

Authors:  M A Kaplan; M J Prior; R R Ash; K I McKonly; E C Helzner; E B Nelson
Journal:  Arch Fam Med       Date:  1999 May-Jun

5.  A double blind crossover comparison of loperamide with diphenoxylate in the symptomatic treatment of chronic diarrhea.

Authors:  W Pelemans; F Vantrappen
Journal:  Gastroenterology       Date:  1976-06       Impact factor: 22.682

6.  Retrospective population-based analysis of the dose-response (fecal fat excretion) relationship of orlistat in normal and obese volunteers.

Authors:  J Zhi; A T Melia; R Guerciolini; J Chung; J Kinberg; J B Hauptman; I H Patel
Journal:  Clin Pharmacol Ther       Date:  1994-07       Impact factor: 6.875

7.  Mechanism of the antidiarrheal effect of loperamide.

Authors:  L R Schiller; C A Santa Ana; S G Morawski; J S Fordtran
Journal:  Gastroenterology       Date:  1984-06       Impact factor: 22.682

8.  Human intestinal motor activity and transport: effects of a synthetic opiate.

Authors:  G Kachel; H Ruppin; J Hagel; W Barina; M Meinhardt; W Domschke
Journal:  Gastroenterology       Date:  1986-01       Impact factor: 22.682

9.  Double-blind cross-over study comparing loperamide, codeine and diphenoxylate in the treatment of chronic diarrhea.

Authors:  K R Palmer; C L Corbett; C D Holdsworth
Journal:  Gastroenterology       Date:  1980-12       Impact factor: 22.682

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

Authors:  M Read; N W Read; D C Barber; H L Duthie
Journal:  Dig Dis Sci       Date:  1982-09       Impact factor: 3.199

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  6 in total

1.  Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: Design and methods.

Authors:  J Eric Jelovsek; Alayne D Markland; William E Whitehead; Matthew D Barber; Diane K Newman; Rebecca G Rogers; Keisha Dyer; Anthony Visco; Vivian W Sung; Gary Sutkin; Susan F Meikle; Marie G Gantz
Journal:  Contemp Clin Trials       Date:  2015-08-18       Impact factor: 2.226

Review 2.  Orlistat-associated adverse effects and drug interactions: a critical review.

Authors:  Theodosios D Filippatos; Christos S Derdemezis; Irene F Gazi; Eleni S Nakou; Dimitri P Mikhailidis; Moses S Elisaf
Journal:  Drug Saf       Date:  2008       Impact factor: 5.606

3.  Incontinence: an underappreciated problem in obesity and bariatric surgery.

Authors:  Adil E Bharucha
Journal:  Dig Dis Sci       Date:  2010-09       Impact factor: 3.199

4.  Controlling faecal incontinence in women by performing anal exercises with biofeedback or loperamide: a randomised clinical trial.

Authors:  J Eric Jelovsek; Alayne D Markland; William E Whitehead; Matthew D Barber; Diane K Newman; Rebecca G Rogers; Keisha Dyer; Anthony G Visco; Gary Sutkin; Halina M Zyczynski; Benjamin Carper; Susan F Meikle; Vivian W Sung; Marie G Gantz
Journal:  Lancet Gastroenterol Hepatol       Date:  2019-07-15

5.  Are Obese Patients at an Increased Risk of Pelvic Floor Dysfunction Compared to Non-obese Patients?

Authors:  Isaac José Felippe Corrêa Neto; Rodrigo Ambar Pinto; José Marcio Neves Jorge; Marco Aurélio Santo; Leonardo Alfonso Bustamante-Lopez; Ivan Cecconello; Sérgio Carlos Nahas
Journal:  Obes Surg       Date:  2017-07       Impact factor: 4.129

Review 6.  Drug treatment for faecal incontinence in adults.

Authors:  Muhammad Imran Omar; Cameron Edwin Alexander
Journal:  Cochrane Database Syst Rev       Date:  2013-06-11
  6 in total

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