| The physical properties of rectal contents have effects on anorectal continence: insights from a study into the cause of fecal spotting on orlistat. | |
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MedLine Citation:
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PMID: 15657667 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The intermittent loss of oil or stool ("spotting") is an adverse effect that occurs in patients taking orlistat; the pathophysiology is unknown. This study was designed to investigate the local effects of orlistat, free fatty acids, and the effects of the physical properties of rectal contents on anorectal function and continence. METHODS: Anorectal physiology and continence function were assessed in ten healthy patients after the application of four test enemas: 1) high-viscosity stool substitute, 2) stool substitute with free fatty acid, 3) low-viscosity oil with placebo, 4) oil with orlistat. Rectal function and capacity were assessed by barostat techniques. Anal resting pressure, squeeze pressure, and squeeze duration were assessed by manometry. A retention test was performed using the same enemas as a quantitative assessment of continence. RESULTS: Orlistat and free fatty acid had no adverse effects on anorectal function or continence. For each enema, the maximum volume retained correlated with rectal capacity (r = 0.85; P < 0.01). Continence during rectal filling was better maintained for high-viscosity stool substitute than low-viscosity oil enemas (P < 0.03). Patients able to maintain effective squeeze pressure retained more of the low-viscosity enemas than those with short squeeze duration (P < 0.01); in contrast, the volume retained of high-viscosity enemas was unaffected by anal sphincter function. CONCLUSIONS: The physical properties of rectal contents, rectal capacity, and voluntary anal sphincter function have effects on continence function in healthy patients. The occurrence of spotting may depend on both intrinsic anorectal function and the effects of orlistat on the volume and physical properties of stool. |
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Authors:
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Mark Fox; Werner Schwizer; Dieter Menne; Bernadette Stutz; Michael Fried; Miriam Thumshirn |
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Publication Detail:
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Type: Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 47 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2004 Dec |
Date Detail:
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Created Date: 2005-01-19 Completed Date: 2005-02-03 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 2147-56 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology and Hepatology, University Hospital of Zürich, Zürich, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Adult Anal Canal / physiopathology Analysis of Variance Anti-Obesity Agents / administration & dosage, adverse effects*, metabolism Causality Cross-Over Studies Defecation Enema Fatty Acids, Nonesterified / adverse effects, analysis Fecal Incontinence / chemically induced*, metabolism, physiopathology Feces* / chemistry Female Gastrointestinal Contents / chemistry Humans Intestinal Absorption Lactones / administration & dosage, adverse effects*, metabolism Linear Models Male Manometry Metabolic Clearance Rate Plant Oils Rectum / physiopathology Sensation Viscosity |
| Chemical | |
Reg. No./Substance:
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0/Anti-Obesity Agents; 0/Fatty Acids, Nonesterified; 0/Lactones; 0/Plant Oils; 96829-58-2/orlistat |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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