Effects of clonidine in women with fecal incontinence

Adil Eddie Bharucha, Joel Garland Fletcher, Michael Camilleri, Jessica Edge, Paula Carlson, Alan R. Zinsmeister

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background & Aims: Some women with urge-predominant fecal incontinence (FI) have diarrhea-predominant irritable bowel syndrome and a stiffer and hypersensitive rectum. We evaluated the effects of the α2-adrenergic agonist clonidine on symptoms and anorectal functions in women with FI in a prospective, placebo-controlled trial. Methods: We assessed bowel symptoms and anorectal functions (anal pressures, rectal compliance, and sensation) in 43 women (age, 58 ± 2 y) with urge-predominant FI, randomly assigned to groups given oral clonidine (0.1 mg, twice daily) or placebo for 4 weeks. Before and after administration of the medication, anal pressures were evaluated by manometry, and rectal compliance and sensation were measured using a barostat. Anal sphincter injury was evaluated by endoanal magnetic resonance imaging. Bowel symptoms were recorded in daily and weekly diaries. The primary end point was the FI and Constipation Assessment symptom severity score. Results: FI scores decreased from 9.1 ± 0.3 to 7.6 ± 0.5 among subjects given placebo and from 8.1 ± 0.4 to 6.5 ± 0.6 among patients given clonidine. Clonidine did not affect FI symptom severity, bowel symptoms (stool consistency or frequency), anal pressures, rectal compliance, or sensation compared with placebo. However, when baseline data were used to categorize subjects as those with or without diarrhea, clonidine reduced the proportion of loose stools in patients with diarrhea only (P= .018). Clonidine also reduced the proportion of days with FI in patients with diarrhea (P= .0825). Conclusions: Overall, clonidine did not affect bowel symptoms, fecal continence, or anorectal functions, compared with placebo, in women with urge-predominant FI. Among patients with diarrhea, clonidine increased stool consistency, with a borderline significant improvement in fecal continence. ClinicalTrials.gov, Number NCT00884832.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
Volume12
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Fecal Incontinence
Clonidine
Diarrhea
Placebos
Compliance
Pressure
Adrenergic Agonists
Symptom Assessment
Irritable Bowel Syndrome
Manometry
Anal Canal
Constipation
Rectum
Magnetic Resonance Imaging
Wounds and Injuries

Keywords

  • FICA
  • IBS
  • MRI
  • Randomized Controlled Trial
  • Stool Consistency

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Effects of clonidine in women with fecal incontinence. / Bharucha, Adil Eddie; Fletcher, Joel Garland; Camilleri, Michael; Edge, Jessica; Carlson, Paula; Zinsmeister, Alan R.

In: Clinical Gastroenterology and Hepatology, Vol. 12, No. 5, 2014.

Research output: Contribution to journalArticle

@article{b90d16ecdd9e48e78187a898c6379cfb,
title = "Effects of clonidine in women with fecal incontinence",
abstract = "Background & Aims: Some women with urge-predominant fecal incontinence (FI) have diarrhea-predominant irritable bowel syndrome and a stiffer and hypersensitive rectum. We evaluated the effects of the α2-adrenergic agonist clonidine on symptoms and anorectal functions in women with FI in a prospective, placebo-controlled trial. Methods: We assessed bowel symptoms and anorectal functions (anal pressures, rectal compliance, and sensation) in 43 women (age, 58 ± 2 y) with urge-predominant FI, randomly assigned to groups given oral clonidine (0.1 mg, twice daily) or placebo for 4 weeks. Before and after administration of the medication, anal pressures were evaluated by manometry, and rectal compliance and sensation were measured using a barostat. Anal sphincter injury was evaluated by endoanal magnetic resonance imaging. Bowel symptoms were recorded in daily and weekly diaries. The primary end point was the FI and Constipation Assessment symptom severity score. Results: FI scores decreased from 9.1 ± 0.3 to 7.6 ± 0.5 among subjects given placebo and from 8.1 ± 0.4 to 6.5 ± 0.6 among patients given clonidine. Clonidine did not affect FI symptom severity, bowel symptoms (stool consistency or frequency), anal pressures, rectal compliance, or sensation compared with placebo. However, when baseline data were used to categorize subjects as those with or without diarrhea, clonidine reduced the proportion of loose stools in patients with diarrhea only (P= .018). Clonidine also reduced the proportion of days with FI in patients with diarrhea (P= .0825). Conclusions: Overall, clonidine did not affect bowel symptoms, fecal continence, or anorectal functions, compared with placebo, in women with urge-predominant FI. Among patients with diarrhea, clonidine increased stool consistency, with a borderline significant improvement in fecal continence. ClinicalTrials.gov, Number NCT00884832.",
keywords = "FICA, IBS, MRI, Randomized Controlled Trial, Stool Consistency",
author = "Bharucha, {Adil Eddie} and Fletcher, {Joel Garland} and Michael Camilleri and Jessica Edge and Paula Carlson and Zinsmeister, {Alan R.}",
year = "2014",
doi = "10.1016/j.cgh.2013.06.035",
language = "English (US)",
volume = "12",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - Effects of clonidine in women with fecal incontinence

AU - Bharucha, Adil Eddie

AU - Fletcher, Joel Garland

AU - Camilleri, Michael

AU - Edge, Jessica

AU - Carlson, Paula

AU - Zinsmeister, Alan R.

PY - 2014

Y1 - 2014

N2 - Background & Aims: Some women with urge-predominant fecal incontinence (FI) have diarrhea-predominant irritable bowel syndrome and a stiffer and hypersensitive rectum. We evaluated the effects of the α2-adrenergic agonist clonidine on symptoms and anorectal functions in women with FI in a prospective, placebo-controlled trial. Methods: We assessed bowel symptoms and anorectal functions (anal pressures, rectal compliance, and sensation) in 43 women (age, 58 ± 2 y) with urge-predominant FI, randomly assigned to groups given oral clonidine (0.1 mg, twice daily) or placebo for 4 weeks. Before and after administration of the medication, anal pressures were evaluated by manometry, and rectal compliance and sensation were measured using a barostat. Anal sphincter injury was evaluated by endoanal magnetic resonance imaging. Bowel symptoms were recorded in daily and weekly diaries. The primary end point was the FI and Constipation Assessment symptom severity score. Results: FI scores decreased from 9.1 ± 0.3 to 7.6 ± 0.5 among subjects given placebo and from 8.1 ± 0.4 to 6.5 ± 0.6 among patients given clonidine. Clonidine did not affect FI symptom severity, bowel symptoms (stool consistency or frequency), anal pressures, rectal compliance, or sensation compared with placebo. However, when baseline data were used to categorize subjects as those with or without diarrhea, clonidine reduced the proportion of loose stools in patients with diarrhea only (P= .018). Clonidine also reduced the proportion of days with FI in patients with diarrhea (P= .0825). Conclusions: Overall, clonidine did not affect bowel symptoms, fecal continence, or anorectal functions, compared with placebo, in women with urge-predominant FI. Among patients with diarrhea, clonidine increased stool consistency, with a borderline significant improvement in fecal continence. ClinicalTrials.gov, Number NCT00884832.

AB - Background & Aims: Some women with urge-predominant fecal incontinence (FI) have diarrhea-predominant irritable bowel syndrome and a stiffer and hypersensitive rectum. We evaluated the effects of the α2-adrenergic agonist clonidine on symptoms and anorectal functions in women with FI in a prospective, placebo-controlled trial. Methods: We assessed bowel symptoms and anorectal functions (anal pressures, rectal compliance, and sensation) in 43 women (age, 58 ± 2 y) with urge-predominant FI, randomly assigned to groups given oral clonidine (0.1 mg, twice daily) or placebo for 4 weeks. Before and after administration of the medication, anal pressures were evaluated by manometry, and rectal compliance and sensation were measured using a barostat. Anal sphincter injury was evaluated by endoanal magnetic resonance imaging. Bowel symptoms were recorded in daily and weekly diaries. The primary end point was the FI and Constipation Assessment symptom severity score. Results: FI scores decreased from 9.1 ± 0.3 to 7.6 ± 0.5 among subjects given placebo and from 8.1 ± 0.4 to 6.5 ± 0.6 among patients given clonidine. Clonidine did not affect FI symptom severity, bowel symptoms (stool consistency or frequency), anal pressures, rectal compliance, or sensation compared with placebo. However, when baseline data were used to categorize subjects as those with or without diarrhea, clonidine reduced the proportion of loose stools in patients with diarrhea only (P= .018). Clonidine also reduced the proportion of days with FI in patients with diarrhea (P= .0825). Conclusions: Overall, clonidine did not affect bowel symptoms, fecal continence, or anorectal functions, compared with placebo, in women with urge-predominant FI. Among patients with diarrhea, clonidine increased stool consistency, with a borderline significant improvement in fecal continence. ClinicalTrials.gov, Number NCT00884832.

KW - FICA

KW - IBS

KW - MRI

KW - Randomized Controlled Trial

KW - Stool Consistency

UR - http://www.scopus.com/inward/record.url?scp=84898771108&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898771108&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2013.06.035

DO - 10.1016/j.cgh.2013.06.035

M3 - Article

VL - 12

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 5

ER -