title: The effects of clonidine on symptoms and anorectal sensorimotor function in women with faecal incontinence.
abstract: BACKGROUND
  Women with faecal incontinence and rectal urgency have increased rectal stiffness and sensation.
  
  
  OBJECTIVE
  To evaluate the effects of clonidine, an alpha(2) -adrenergic agonist, in faecal incontinence.
  
  
  METHODS
  In this open-label uncontrolled study, bowel symptoms and anorectal functions (anal pressures, rectal compliance, and sensation) were assessed before and during treatment with transdermal clonidine (0.2 mg daily, 4 weeks) in 12 women with urge-predominant faecal incontinence.
  
  
  RESULTS
  Clonidine reduced the frequency (17.8 +/- 3.1 before vs. 8.8 +/- 3.9 after, P = 0.03) and number of days with faecal incontinence (11.8 +/- 1.6 before vs. 6.1 +/- 1.8 after, P = 0.02), faecal incontinence symptom severity score (max = 13, 8.3 +/- 0.7 vs. 5.6 +/- 0.9, P < 0.01), and allowed patients to defer defecation for a longer duration (P = 0.03). Although overall effects on anorectal functions were not significant, the treatment-associated reduction in faecal incontinence episodes was associated with increased rectal compliance (r = -0.58, P < 0.05) and reduced rectal sensation. (r = -0.73, P = 0.007 vs. desire to defecate pressure threshold).
  
  
  CONCLUSIONS
  Clonidine improves symptoms in women with faecal incontinence; this improvement is associated with increased rectal compliance and reduced rectal sensitivity. A controlled study is necessary to confirm these observations.
authors.affiliation: Department of Medicine, Rochester, MN, USA. bharucha.adil@mayo.edu
authors.forename: A E
authors.initials: AE
authors.lastname: Bharucha
authors.forename: B M
authors.initials: BM
authors.lastname: Seide
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
mesh_terms: D003000:Clonidine / Q000627:therapeutic use*; D003672:Defecation / Q000502:physiology*; D005242:Fecal Incontinence / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D012677:Sensation; D012720:Severity of Illness Index; D013565:Sympatholytics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013565:Sympatholytics; D003000:Clonidine