Efficacy and Mechanisms of Pharmacologic Treatment of Fecal Incontinence

Fecal incontinence (FI) affects 4-24% adults in the community and greatly impacts quality of
life. Both fiber and loperamide are common, first-line treatments for diarrhea-associated FI
in primary care. No known studies exist that compare fiber and loperamide for
diarrhea-predominant FI. Further knowledge is needed to define which treatment is more
effective and to compare drug tolerability (side effects) for FI. This study will also look
at changes in quality of life with treatment and potential mechanisms of drug treatment.

Inclusion Criteria:

- weekly fecal incontinence

Exclusion Criteria:

- fecal impaction

- inability to complete a baseline 1-week bowel diary

- rectal prolapse

- any prior radiation to the pelvis

- colo-rectal cancer

- rectal fistula

- inflammatory bowel disease

- neurological diseases (spinal cord injury, multiple sclerosis, Parkinson's disease)

- constipation (<2 bowel movements/week) or total colectomy