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 of topical oestrogens (TE) in controlling symptoms of FI in postmenopausal women. Hypothesis The application of TE in postmenopausal women with FI improves continence.


METHODS
We performed a prospective double-blind randomized trial applying TE to the anal mucosa in postmenopausal women with FI.


METHODS
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).


CONCLUSIONS
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.
Pinedo
G
G
Colorectal Unit, Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile. gpinedo@med.puc.cl
García
E
E
Zárate
A J
AJ
León
F
F
Bellolio
F
F
Molina
M E
ME
Viviani
P
P
Zúñiga
A
A
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D003008:Cloprostenol / Q000008:administration & dosage*; D004311:Double-Blind Method; D004964:Estriol / Q000008:administration & dosage*; D005242:Fecal Incontinence / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause
D003008:Cloprostenol; D004964:Estriol