Read M, Read N W, Barber D C, Duthie H L
Dig Dis Sci. 1982 Sep;27(9):807-14. doi: 10.1007/BF01391374.
We have investigated the effect of loperamide (4 mg tds) on the continence to a standard volume of rectally infused saline and anorectal manometry in 26 patients complaining of chronic diarrhea complicated by fecal incontinence and severe urgency. Each patient was treated for one week with loperamide (4 mg tds) and for one week with an identical placebo in a double-blind cross-over trial. Our results showed that as well as its established effects of improving stool consistency and reducing stool weight, frequency and episodes of incontinence and severe urgency, loperamide also significantly improved continence to a standard volume of rectally infused saline. This action was associated with an increase in the maximum basal sphincter pressure, an increase in the rectal volume required to abolish recovery of the rectoanal inhibitory reflex, and a reduction in rectal compliance. These results suggest that loperamide may have a specific action on the anal sphincter, which may aid continence in patients who complain of diarrhea and fecal incontinence.
我们研究了洛哌丁胺（4毫克，每日三次）对26例主诉慢性腹泻并伴有大便失禁和严重便急的患者直肠注入标准量生理盐水时的控便能力及肛门直肠测压的影响。在一项双盲交叉试验中，每位患者接受一周洛哌丁胺（4毫克，每日三次）治疗，以及一周相同安慰剂治疗。我们的结果显示，除了其已证实的改善大便性状、减轻大便重量、频率以及失禁和严重便急发作次数的作用外，洛哌丁胺还显著改善了直肠注入标准量生理盐水时的控便能力。这一作用与最大基础括约肌压力增加、消除直肠肛门抑制反射恢复所需的直肠容量增加以及直肠顺应性降低有关。这些结果表明，洛哌丁胺可能对肛门括约肌有特定作用，这可能有助于改善腹泻和大便失禁患者的控便能力。
