Document Detail


The physical properties of rectal contents have effects on anorectal continence: insights from a study into the cause of fecal spotting on orlistat.
MedLine Citation:
PMID:  15657667     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mark Fox; Werner Schwizer; Dieter Menne; Bernadette Stutz; Michael Fried; Miriam Thumshirn
Related Documents :
21138617 - Sildenafil therapy for neonatal and childhood pulmonary hypertensive vascular disease.
8459377 - Effect of anoreceptive intercourse on anorectal function.
18845037 - Oesophageal function in tracheoesophageal fistula speakers after laryngectomy.
9152187 - Prediction of incontinence following low anterior resection for rectal carcinoma.
6838047 - Early effects of oxygen administration and prognosis in chronic obstructive pulmonary d...
20498217 - Increased prevalence of diastolic dysfunction in rheumatoid arthritis.
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  47     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-01-19     Completed Date:  2005-02-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2147-56     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology and Hepatology, University Hospital of Zürich, Zürich, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
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


Previous Document:  Injectable silicone biomaterial for fecal incontinence caused by internal anal sphincter dysfunction...
Next Document:  Prevention of peritoneal adhesions by intraperitoneal administration of vitamin E: an experimental s...