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Cochrane Database of Systematic Reviews

Drug treatment for faecal incontinence in adults

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DOI:
https://doi.org/10.1002/14651858.CD002116.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 11 junio 2013see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:
  1. Grupo Cochrane de Incontinencia

Copyright:
  1. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Autores

Contributions of authors

One review authors (M. Cheetham) wrote the initial protocol for the review. Three review authors (M. Cheetham, Mirian Brazzelli, and C. Norton) assessed the pertinence and quality of included studies. All review authors independently extracted data from trials reports, interpreted the results, and contributed towards writing the final review. For the first update, CG screened the abstracts identified from the updated search and added two new included trials. For 2013 update, Muhammad Imran Omar (MO) and Cameron Edwin Alexander (CA) screened all the abstracts and included three additional trials. MO and CA re‐assessed the risk of bias of all the included trials in accordance with the current methodology and contributed in the writing of the manuscript for this update.

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • National Institute for Health Research (NIHR), UK.

    The National Institute for Health Research (NIHR) is the largest single funder of the Cochrane Incontinence Group.

Declarations of interest

None known.

Acknowledgements

We thank all members of the Cochrane Incontinence Review Group in Aberdeen for their assistance with the review. The review authors would like to acknowledge the contributions of the previous review authors Mark J Cheetham, Miriam Brazzelli, Christine Norton, Cathryn MA Glazener and Jean C Hay‐Smith. The review authors are grateful to Euan Fisher and Mayret Castillo for translation and data extraction of one trial (Lumi 2009).

Version history

Published

Title

Stage

Authors

Version

2013 Jun 11

Drug treatment for faecal incontinence in adults

Review

Muhammad Imran Omar, Cameron Edwin Alexander

https://doi.org/10.1002/14651858.CD002116.pub2

2002 Jul 22

Drug treatment for faecal incontinence in adults

Review

Mark J Cheetham, Miriam Brazzelli, Christine C Norton, Cathryn MA Glazener

https://doi.org/10.1002/14651858.CD002116

Keywords

MeSH

PRISMA study flow diagram.
Figuras y tablas -
Figure 1

PRISMA study flow diagram.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figuras y tablas -
Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figuras y tablas -
Figure 3

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Study

Drug

Placebo

Significance

Loperamide versus placebo

Hallgren 1994 #

3/28 during the day
1/28 during the night

7/28 during the day
11/28 during the night

Sun 1997 #

4/11 in 24 hours
(loperamide oxide)

8/11 in 24 hours

P < 0.05

Diphenoxylate + atropine versus placebo

Harford 1980 #

0/15 in 24 hours

3/15 in 24 hours

Phenylephrine gel versus placebo

Carapeti 2000b #

8/12

12/12

Sodium valproate versus placebo

Kusunoki 1990 #

3/17

10/17

Figuras y tablas -
Analysis 1.1

Comparison 1 DRUG VERSUS PLACEBO, Outcome 1 Number of people failing to achieve full continence.

Study

Drug

Placebo

Loperamide versus placebo

Read 1982 #

Episodes of urgency: 7/26
Incontinence episodes: 19/26

Per cent unformed stool per week (mean, range): 40% (0%‐100%)

Episodes of urgency: 23/26
Incontinence episodes: 24/26

Per cent unformed stool per week (mean, range): 57% (0%‐100%) (P < 0.001)

Sun 1997 #

No improvement in stool consistency: 2/11

Per cent of days with unformed stools: 33%

(loperamide oxide)

No improvement in stool consistency: 8/11

Per cent of days with unformed stools: 66% (P < 0.02)

Diphenoxylate + atropine versus placebo

Harford 1980 #

No improvement in stool weight and frequency: 3/15

No improvement in stool weight and frequency: 3/15

Phenylephrine gel versus placebo

Carapeti 2000a #

No subjective improvement: 30/36

34/36

Carapeti 2000b #

No undefined 'improvement': 6/12

11/12

Figuras y tablas -
Analysis 1.2

Comparison 1 DRUG VERSUS PLACEBO, Outcome 2 Number of people failing to improve incontinence.

Study

Drug

Placebo

Loperamide versus placebo

Read 1982 #

Mean 0.6
(range 0‐6)
per week

Mean 0.9 (range 0‐6)

Phenylephrine cream versus placebo

Lumi 2009

Median 5.4

(range 0‐14)

Median 9

(range 0‐19)

Figuras y tablas -
Analysis 1.3

Comparison 1 DRUG VERSUS PLACEBO, Outcome 3 Number of faecal incontinence episodes.

Study

Drug

Placebo

Significance

Loperamide versus placebo

Hallgren 1994 #

N 28 mean 4.24 (SD 1.86)

N 28 mean 6.43 (SD 1.99)

Read 1982 #

N 26 mean 1.6 (range 1‐6.3)

N 26 mean 2.4 (range 0‐7.7)

P < 0.001 Wilcoxon's rank sum test for paired data

Sun 1997 #

N 11 mean 1.43 (SD 1)
(loperamide oxide)

N 11 mean 2 (SD 1)

P < 0.02

Diphenoxylate + atropine versus placebo

Harford 1980 #

N 15 mean 2.6 (SD 2.71)

N 15 mean 4.9 (SD 3.1)

Sodium valproate versus placebo

Kusunoki 1990 #

N 17 mean 5.98 (SD 2.97)

N 17 mean 9.65 (SD 3.59)

Figuras y tablas -
Analysis 1.4

Comparison 1 DRUG VERSUS PLACEBO, Outcome 4 Frequency of defecation (per day).

Study

Drug

Placebo

Significance

Loperamide versus placebo

Sun 1997 #

visual analogue incontinence
scale:
N 11 mean 26 (SD 36)
loperamide oxide

N 11 mean 43 (SD 37)

P = 0.12

Phenylephrine gel versus placebo

Carapeti 2000a #

N 18 mean 12.5 (SD 3.4)

N 18 mean 12.6 (SD 4.2)

No significant difference

Carapeti 2000b #

N 12 mean 12.2 (SD 5.7)

N 12 mean 16.5 (SD 4.4)

Park 2007

Anal incontinence evaluated with Faecal Incontinence Severity Index (FISI) and reported as mean (SD)

n = 17; Baseline: 32.5 (14.5); After: 32.3 (14.7) P = 0.940

Anal incontinence evaluated with Faecal Incontinence Severity Index (FISI) and reported as mean (SD)

n = 12; Baseline: 32.1 (11.2); After: 32.4 (14.4) P = 0.626

Zinc aluminium ointment versus placebo ointment

Pinedo 2012

Wexner Faecal Incontinence Score reported before and after the treatment and reported as mean (SD)

n = 24; Before: 16.6 (6‐20); After: 8.5 (0‐11) P = < 0.001

Wexner Faecal Incontinence Score reported before and after the treatmentand reported as mean (SD)

n = 20; Before: 16.7 (5‐18); After: 13.1 (5‐17) P = 0.02

There was a significant difference in the final scores favouring the treatment group (P = 0.001)

Figuras y tablas -
Analysis 1.5

Comparison 1 DRUG VERSUS PLACEBO, Outcome 5 Faecal incontinence score.

Study

Drug

Placebo

Significance

Loperamide versus placebo

Read 1982 #

N 26 mean 102 (range 0‐467)

N 26 mean 186 (range 0‐466)

P < 0.001 Wilcoxon's rank sum test for paired data

Sun 1997 #

N 11 mean 282 (SD 212)
(loperamide oxide)

N 11 mean 423 (SD 163)

P = 0.11

Diphenoxylate + atropine versus placebo

Harford 1980 #

N 15 mean 256 (SD 333)

N 15 mean 460 (SD 581)

Figuras y tablas -
Analysis 1.6

Comparison 1 DRUG VERSUS PLACEBO, Outcome 6 Stool weight (grammes in 24 hours).

Study

Drug

Placebo

Loperamide versus placebo

Hallgren 1994 #

During the day: 1/28
During the night:
1/28

During the day:
3/28
During the night: 6/28

Figuras y tablas -
Analysis 1.7

Comparison 1 DRUG VERSUS PLACEBO, Outcome 7 Number of people using pads.

Study

Drug

Placebo

Loperamide versus placebo

Read 1982 #

18/26 (constipation 11, diarrhoea 4, nausea and vomiting 3, abdominal pain 2)

1/26 (abdominal pain)

Sun 1997 #

6/11 (headache, nausea, dizzyness, abdominal pain, constipation)
(loperamide oxide)

3/11

Phenylephrine gel versus placebo

Carapeti 2000a #

3/36 (mild dermatitis after phenylephrine gel application, which settled when drug stopped)

0/36

Carapeti 2000b #

0/12

0/12

Cheetham 2001 #

2/10 (burning sensation after phenylephrine gel application, which settled within minutes)

0/10

Park 2007

Dermatitis reaction: 5/17; B = 1/12
Palpitation: 0/17; B = 1/12
Headache: 2/17; B = 0/12

Dermatitis reaction: 1/12
Palpitation: 1/12
Headache: 0/12

Sodium valproate versus placebo

Kusunoki 1990 #

8/17 (abdominal pain and nausea)

0/17

Zinc aluminium ointment versus placebo ointment

Pinedo 2012

0/24

0/20

Figuras y tablas -
Analysis 1.8

Comparison 1 DRUG VERSUS PLACEBO, Outcome 8 Number of people with adverse effects.

Study

Drug

Placebo

Sodium valproate versus placebo

Kusunoki 1990 #

3/17

9/17

Figuras y tablas -
Analysis 1.9

Comparison 1 DRUG VERSUS PLACEBO, Outcome 9 Number of people with perianal skin problems.

Study

Drug

Placebo

Loperamide versus placebo

Hallgren 1994 #

N 28 mean 62 (SD 16)

versus
N 28 mean 55 (SD 9)

Sun 1997 #

N 11 mean 76 (SD 40)
(loperamide oxide )

N 11 mean 69 (SD 35)

Diphenoxylate + atropine versus placebo

Harford 1980 #

N 15 mean 41 (SD 23)

N 15 mean 39 (SD 19)

Phenylephrine gel versus placebo

Carapeti 2000a #

N 18 mean 65 (SD 21)

N 18 mean 54 (SD 21)

Carapeti 2000b #

N 12 mean 89 (SD 17)

N 12 mean 75 (SD 14)

Cheetham 2001 #

Statistically significant differences between phenylephrine gel (in concentrations of 30% and 40% only)

compared with placebo (P < 0.05)

Sodium valproate versus placebo

Kusunoki 1990 #

N 17 mean 63.6 (SD 12.4)

N 17 mean 42.5 (SD 8.9)

Figuras y tablas -
Analysis 1.10

Comparison 1 DRUG VERSUS PLACEBO, Outcome 10 Maximum resting anal pressure (mmHg).

Study

Domain

Drug (n = 17); reported as mean (SD)

Placebo (n = 12); reported as mean (SD)

Phenylephrine gel versus placebo

Park 2007

Resting pressure (mmHg)

Baseline: 30.0 (12.3); After: 27.3 (12.7) P = 0.362

Baseline: 32.6 (14.2); After: 27.2 (15.0) P = 0.306

Park 2007

Squeezing pressure (mmHg)

Baseline: 143.3 (60.5); After: 160.4 (76.9) P = 0.083

Baseline: 152.6 (86.5); After: 147.1 (76.5) P = 0.625

Park 2007

Sustained duration (s)

Baseline: 41.9 (24.5); After: 44.9 (48.3) P = 0.848

Baseline: 39.6 (24.4); After: 32.8 (14.4) P = 0.187

Park 2007

Sphincter length (cm)

Baseline: 3.2 (0.9); After: 3.4 (0.8) P = 0.368

Baseline: 3.5 (0.8); After: 3.4 (0.8) P = 0.743

Park 2007

High pressure zone (cm)

Baseline: 2.4 (2.1); After: 1.9 (0.5) P = 0.378

Baseline: 2.1 (0.9); After: 2.3 (0.9) P = 0.556

Figuras y tablas -
Analysis 1.11

Comparison 1 DRUG VERSUS PLACEBO, Outcome 11 Manometry.

Study

Drug

Placebo

Loperamide versus placebo

Hallgren 1994 #

N 28 mean 223 (SD 82)

N 28 mean 219 (SD 93)

Sun 1997 #

N 11 mean 163 (SD 86)
(loperamide oxide)

N 11 mean 155 (SD 85)

Diphenoxylate + atropine versus placebo

Harford 1980 #

N 15 mean 94 (SD 68)

N 15 mean 96 (SD 68)

Figuras y tablas -
Analysis 1.12

Comparison 1 DRUG VERSUS PLACEBO, Outcome 12 Maximum anal squeeze pressure (mmHg).

Study

Drug

Placebo

Diphenoxylate + atropine versus placebo

Harford 1980 #

N 15 mean 87 (SD 127)

N 15 mean 86 (SD 127)

Figuras y tablas -
Analysis 1.13

Comparison 1 DRUG VERSUS PLACEBO, Outcome 13 Duration of squeeze (seconds).

Study

Drug

Placebo

Loperamide versus placebo

Hallgren 1994 #

N 28 mean 29.6 (SD 11.7)

N 28 mean 26.5 (SD 14.9)

Diphenoxylate + atropine versus placebo

Harford 1980 #

N 15 mean 12 (SD 12)

N 15 mean 31 (SD 62)

Figuras y tablas -
Analysis 1.14

Comparison 1 DRUG VERSUS PLACEBO, Outcome 14 Sensory threshold (cm water).

Study

Drug

Placebo

Significance

Loperamide versus placebo

Sun 1997 #

N 11 mean 223 (SD 274)
(loperamide oxide)

versus
N 11 mean 150 (SD 208 )

P = 0.07

Diphenoxylate + atropine versus placebo

Harford 1980 #

N 15 mean 492 (SD 461)

N 15 mean 486 (SD 364)

Figuras y tablas -
Analysis 1.15

Comparison 1 DRUG VERSUS PLACEBO, Outcome 15 Saline retention test (mL).

Study

Drug

Placebo

Significance

Loperamide versus placebo

Sun 1997 #

N 11 mean 61 hours (SD 13)
(loperamide oxide)

N 11 mean 39 hours (SD 15)

Significantly prolonged (P < 0.001) in patients taking loperamide oxide

Figuras y tablas -
Analysis 1.16

Comparison 1 DRUG VERSUS PLACEBO, Outcome 16 Whole‐gut transit time.

Study

Drug

Placebo

Significance

Ryan 1974

154 items during trial period

332 items

P < 0.01

Figuras y tablas -
Analysis 1.17

Comparison 1 DRUG VERSUS PLACEBO, Outcome 17 Number of soiled items (bedding and or clothing).

Study

Drug

Placebo

Significance

Laxative (lactulose) versus placebo

Ryan 1974

283 days of help

322 days of help

P < 0.05 during trial period

Figuras y tablas -
Analysis 1.18

Comparison 1 DRUG VERSUS PLACEBO, Outcome 18 Help required from nurses.

Study

Domains

Drug (n = 17); reported as mean (SD)

Placebo (n = 12); reported as mean (SD)

Zinc aluminium ointment versus placebo ointment

Pinedo 2012

Lifestyle

Baseline: 2.49 (1.06); After: 3.58 (1.18) P = < 0.001

Baseline: 2.50 (1.01); After: 2.55 (1.03) P = 0.151

Pinedo 2012

Conduct

Baseline: 2.19 (1.02); After: 3.12 (1.16) P = < 0.001

Baseline: 2.17 (0.91); After: 2.37 (1.13) P = 0.104

Pinedo 2012

Embarrassment

Baseline: 1.54 (0.82); After: 2.5 (1.32) P = < 0.001

Baseline: 1.56 (0.74); After: 1.76 (0.84) P = 0.043

Pinedo 2012

Depression

Baseline: 2.51 (1.01); After: 3.48 (1.17) P = 0.001

Baseline: 2.46 (1.02); After: 2.71 (1.13) P = 0.093

Phenylephrine gel versus placebo

Park 2007

Lifestyle

Baseline: 2.9 (0.8); After: 2.9 (1.0) P = 0.801

Baseline: 2.7 (0.5); After: 3.0 (0.8) P = 0.269

Park 2007

Coping

Baseline: 2.5 (0.9); After: 2.8 (0.9) P= 0.110

Baseline: 2.5 (0.5); After: 2.8 (0.5) P = 0.119

Park 2007

Depression

Baseline: 3.2 (0.7); After: 3.2 (0.8) P = 0.415

Baseline: 3.1 (0.5); After: 3.2 (0.5) P = 0.554

Park 2007

Embarrassment

Baseline: 2.7 (0.7); After: 3.0 (0.7) P = 0.090

Baseline: 2.7 (0.6); After: 2.6 (0.8) P = 0.855

Figuras y tablas -
Analysis 1.19

Comparison 1 DRUG VERSUS PLACEBO, Outcome 19 Faecal Incontinence Quality of Life (FIQL) score.

Study

Loperamide

Codeine

Diphenox. + atropine

Significance

Solid stool (%)

Palmer 1980 #

67.8% (SD 34)

58.4% (SD 25.9)

36.3% (SD 33.3)

Diphenoxylate was associated with a signficantly smaller percentage of solid stools than either loperamide or codeine (P < 0.01)

Number of people with faecal incontinence

Palmer 1980 #

2/25

3/25

6/25

Stool frequency

Palmer 1980 #

N 15 mean 1.8 (SD 0.3)

N 15 mean 1.9 (SD 0.3)

N 15 mean 1.9 (SD 0.3)

Number of people with urgency

Palmer 1980 #

3/16

4/17

9/17

Diphenoxylate was significantly worse than loperamide or codenine, P < 0.05
(completed treatment periods only)

Adverse effects

Palmer 1980 #

22 in 10/25 patients

29 in 12/25 patients

39 in 12/25 patients

Significantly more adverse effects with diphenoxylate than loperamide, P < 0.05

Adverse effects causing withdrawal

Palmer 1980 #

4/25

4/25

5/25

Figuras y tablas -
Analysis 2.1

Comparison 2 ONE DRUG VERSUS ANOTHER DRUG OR A COMBINATIONOF DRUGS, Outcome 1 Loperamide versus codeine versus diphenoxylate + atropine sulfate.

Study

Lactulose

Lactul + supp + enema

Significance

Number of faecal incontinence episodes in 4 weeks

Chassagne 2000

N 61 mean 24 (SD 11.5 )

N 62 mean 24 (SD 10.8)

P = 0.9

Number of soiled items (bedding and or clothing) in 4 weeks

Chassagne 2000

N 61 mean 80 (SD 16.1)

N 62 mean 78 (SD 20.7)

P = 0.55

Figuras y tablas -
Analysis 2.2

Comparison 2 ONE DRUG VERSUS ANOTHER DRUG OR A COMBINATIONOF DRUGS, Outcome 2 Osmotic laxative (lactulose) versus osmotic laxative + glycerine suppository + enema.

Study

Data

Significance

Cohen 2001 #

Oral administration resulted in decreased stool frequency compared with suppository administration

P < 0.02

Figuras y tablas -
Analysis 2.3

Comparison 2 ONE DRUG VERSUS ANOTHER DRUG OR A COMBINATIONOF DRUGS, Outcome 3 Oral versus suppository administration of loperamide.

Study

Outcome information

Significance

Stool frequency

Fox 2005 #

No effect

Stool consistency

Fox 2005 #

Trend for increased stool consistency from median (IQR) score 0.7 (0.5 to 0.9) with placebo to 0.4 (0.3 to 0.6) with 6 mg dose (0 = all hard, 1 = all liquid)

Faecal incontinence

Fox 2005 #

Less faecal spotting and incontinence with loperamide vs placebo

P < 0.05

Dose response for faecal incontinence

Fox 2005 #

Significant positive dose‐response relationship with increasing dose of loperamide (reduced FI with 2 mg dose, and almost no FI with 4 mg and 6 mg doses)

Adverse effects

Fox 2005 #

Adverse effects: none (specifically no severe constipation with the highest doses)

Figuras y tablas -
Analysis 2.4

Comparison 2 ONE DRUG VERSUS ANOTHER DRUG OR A COMBINATIONOF DRUGS, Outcome 4 Different doses of oral loperamide.

Comparison 1. DRUG VERSUS PLACEBO

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Number of people failing to achieve full continence Show forest plot

Other data

No numeric data

1.1 Loperamide versus placebo

Other data

No numeric data

1.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

1.3 Phenylephrine gel versus placebo

Other data

No numeric data

1.4 Sodium valproate versus placebo

Other data

No numeric data

2 Number of people failing to improve incontinence Show forest plot

Other data

No numeric data

2.1 Loperamide versus placebo

Other data

No numeric data

2.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

2.3 Phenylephrine gel versus placebo

Other data

No numeric data

3 Number of faecal incontinence episodes Show forest plot

Other data

No numeric data

3.1 Loperamide versus placebo

Other data

No numeric data

3.2 Phenylephrine cream versus placebo

Other data

No numeric data

4 Frequency of defecation (per day) Show forest plot

Other data

No numeric data

4.1 Loperamide versus placebo

Other data

No numeric data

4.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

4.3 Sodium valproate versus placebo

Other data

No numeric data

5 Faecal incontinence score Show forest plot

Other data

No numeric data

5.1 Loperamide versus placebo

Other data

No numeric data

5.2 Phenylephrine gel versus placebo

Other data

No numeric data

5.3 Zinc aluminium ointment versus placebo ointment

Other data

No numeric data

6 Stool weight (grammes in 24 hours) Show forest plot

Other data

No numeric data

6.1 Loperamide versus placebo

Other data

No numeric data

6.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

7 Number of people using pads Show forest plot

Other data

No numeric data

7.1 Loperamide versus placebo

Other data

No numeric data

8 Number of people with adverse effects Show forest plot

Other data

No numeric data

8.1 Loperamide versus placebo

Other data

No numeric data

8.2 Phenylephrine gel versus placebo

Other data

No numeric data

8.3 Sodium valproate versus placebo

Other data

No numeric data

8.4 Zinc aluminium ointment versus placebo ointment

Other data

No numeric data

9 Number of people with perianal skin problems Show forest plot

Other data

No numeric data

9.1 Sodium valproate versus placebo

Other data

No numeric data

10 Maximum resting anal pressure (mmHg) Show forest plot

Other data

No numeric data

10.1 Loperamide versus placebo

Other data

No numeric data

10.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

10.3 Phenylephrine gel versus placebo

Other data

No numeric data

10.4 Sodium valproate versus placebo

Other data

No numeric data

11 Manometry Show forest plot

Other data

No numeric data

11.1 Phenylephrine gel versus placebo

Other data

No numeric data

12 Maximum anal squeeze pressure (mmHg) Show forest plot

Other data

No numeric data

12.1 Loperamide versus placebo

Other data

No numeric data

12.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

13 Duration of squeeze (seconds) Show forest plot

Other data

No numeric data

13.1 Diphenoxylate + atropine versus placebo

Other data

No numeric data

14 Sensory threshold (cm water) Show forest plot

Other data

No numeric data

14.1 Loperamide versus placebo

Other data

No numeric data

14.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

15 Saline retention test (mL) Show forest plot

Other data

No numeric data

15.1 Loperamide versus placebo

Other data

No numeric data

15.2 Diphenoxylate + atropine versus placebo

Other data

No numeric data

16 Whole‐gut transit time Show forest plot

Other data

No numeric data

16.1 Loperamide versus placebo

Other data

No numeric data

17 Number of soiled items (bedding and or clothing) Show forest plot

Other data

No numeric data

18 Help required from nurses Show forest plot

Other data

No numeric data

18.1 Laxative (lactulose) versus placebo

Other data

No numeric data

19 Faecal Incontinence Quality of Life (FIQL) score Show forest plot

Other data

No numeric data

19.1 Zinc aluminium ointment versus placebo ointment

Other data

No numeric data

19.2 Phenylephrine gel versus placebo

Other data

No numeric data

Figuras y tablas -
Comparison 1. DRUG VERSUS PLACEBO
Comparison 2. ONE DRUG VERSUS ANOTHER DRUG OR A COMBINATIONOF DRUGS

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Loperamide versus codeine versus diphenoxylate + atropine sulfate Show forest plot

Other data

No numeric data

1.1 Solid stool (%)

Other data

No numeric data

1.2 Number of people with faecal incontinence

Other data

No numeric data

1.3 Stool frequency

Other data

No numeric data

1.4 Number of people with urgency

Other data

No numeric data

1.5 Adverse effects

Other data

No numeric data

1.6 Adverse effects causing withdrawal

Other data

No numeric data

2 Osmotic laxative (lactulose) versus osmotic laxative + glycerine suppository + enema Show forest plot

Other data

No numeric data

2.1 Number of faecal incontinence episodes in 4 weeks

Other data

No numeric data

2.2 Number of soiled items (bedding and or clothing) in 4 weeks

Other data

No numeric data

3 Oral versus suppository administration of loperamide Show forest plot

Other data

No numeric data

4 Different doses of oral loperamide Show forest plot

Other data

No numeric data

4.1 Stool frequency

Other data

No numeric data

4.2 Stool consistency

Other data

No numeric data

4.3 Faecal incontinence

Other data

No numeric data

4.4 Dose response for faecal incontinence

Other data

No numeric data

4.5 Adverse effects

Other data

No numeric data

Figuras y tablas -
Comparison 2. ONE DRUG VERSUS ANOTHER DRUG OR A COMBINATIONOF DRUGS