Fact Versus Fiction: Medication

If diarrhea is causing the incontinence, medication may help. Sometimes doctors recommend using bulk laxatives to help people develop a more regular bowel pattern. Or your doctor may prescribe anti-diarrheal medicines such as loper-amide or diphenoxylate to slow down the bowel and help control the problem. Pharmacological management may include anti-diarrheal/constipating agents and laxatives/stool bulking agents Stopping or substituting any previous medication that causes diarrhea may be helpful in some. There may a benefit from constipating agents in those with coexisting diarrhea. There is little evidence regarding the relative efficacy of medications to other treatments or the use of medications in those with normal stool consistency.

Anti-diarrheal/ constipating agents such as loper-amide, codeine phosphate or diphenoxylate with atropine (co-phenotrope) may be used. Loper-amide reduces stool weight, decreases bowel motility, recto-anal inhibitory reflex sensitivity and may slightly alter resting anal tone. Codeine phosphate and co-phenotrope are less commonly used because greater side effects. In people who have undergone gallbladder removal, the bile acid sequestrant colestyramine may help minor degrees of FI. Laxatives may be used in elderly people where difficulties are secondary to constipation or fecal impaction (paradoxical diarrhea/ overflow incontinence). A common example is lactulose. Regular use of this laxative is intended to prevent recurrence of impaction.

Stool bulking agents may reduce symptoms of obstructed defecation. Bulking agents also absorb water, so may be helpful those with diarrhea. A common side effect is bloating and flatulence. Topical agents to treat and prevent dermatitis may also be used, such as topical anti-fungals when there is evidence of perianal candidiasis or occasionally mild topical anti-inflammatory medication. Prevention of secondary lesions is carried out by perineal cleansing, moisturization, and use of a skin protectant.

All of the above are suggestions from the relevant studies but any and all medical and pharmacological treatment should be evaluated by your personal physician as per your personal condition.