Are topical oestrogens useful in faecal incontinence? Double-blind randomized trial

Background  Histopathological studies have shown the presence of oestrogenic receptors in the anal sphincter, which presumes a role in muscular trophism for circulating oestrogens. This could explain the increase in faecal incontinence (FI) in postmenopausal women. Objective  To evaluate the effect...

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Bibliographic Details
Published in:Colorectal disease 2009-05, Vol.11 (4), p.390-393
Main Authors: Pinedo, G., García, E., Zárate, A. J., León, F., Bellolio, F., Molina, M. E., Viviani, P., Zúñiga, Á.
Format: Article
Language:English
Subjects:
Administration, Topical
Aged
Aged, 80 and over
Cloprostenol - administration & dosage
Double-Blind Method
Estriol - administration & dosage
Faecal incontinence
Fecal Incontinence - drug therapy
Female
Humans
Middle Aged
Postmenopause
randomized trial
topical oestrogen
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Summary:Background  Histopathological studies have shown the presence of oestrogenic receptors in the anal sphincter, which presumes a role in muscular trophism for circulating oestrogens. This could explain the increase in faecal incontinence (FI) in postmenopausal women. Objective  To evaluate the effect of topical oestrogens (TE) in controlling symptoms of FI in postmenopausal women. Hypothesis  The application of TE in postmenopausal women with FI improves continence. Method  We performed a prospective double‐blind randomized trial applying TE to the anal mucosa in postmenopausal women with FI. Study period: 2005–2006. The patients were randomized into two groups: I – topical estriol, II – placebo. In both groups, the ointment was applied three times daily for a period of 6 weeks. We compared Wexner’s FI score and the FI quality of life scale, before commencing and after 6 weeks of application. Results  In this period we evaluated 36 patients. Average age: 67 years (48–84). Group I: 18 patients and group II: 18 patients, one patient was excluded. Wexner’s FI score in group I was 11 (5–18) and 7 (0–19) with pre‐ and postapplication respectively (P = 0.002). Wexner’s FI score in group II was 12 and 9 with pre‐ and postapplication respectively (P = 0.013). When we compared the results between both groups, this was not statistically significant (P = 0.521). Conclusion  There is improvement of continence in both groups that had the ointment applied; nonetheless this study could not show that TE improves FI more than a placebo does.
ISSN:1462-8910
1463-1318
DOI:10.1111/j.1463-1318.2008.01624.x