LOPERAMIDE IMPROVES ANAL-SPHINCTER FUNCTION AND CONTINENCE AFTER RESTORATIVE PROCTOCOLECTOMY

The physiological and clinical effects of loperamide treatment versus placebo were investigated in a randomized, double-blind, crossover stu dy in patients operated with restorative proctocolectomy. Sixteen pati ents operated with endoanal mucosectomy and a handsewn ileal pouch-ana l anastomosis and 14 patients operated with abdominal proctocolectomy and stapling of the pouch to the top of the anal canal were studied. W hile loperamide treatment increased resting anal pressure in both grou ps of patients by approximately 20% (P < 0.05), squeeze pressure was n ot 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, w ith a reduced bowel frequency and an improved nighttime continence, wi th less soiling (P < 0.05) as well as need to wear a protective pad.