Pinedo G, García E, Zárate AJ, León F, Bellolio F, Molina ME, Viviani P, Zúñiga A
Are topical estrogens useful in faecal incontinence? Double blind randomized trial. [JOURNAL ARTICLE]
Colorectal Dis 2008 Jul 11.
Background: Histopathological studies have shown the presence of estrogenic receptors in the anal sphincter, which presumes a role in muscular trophism for circulating estrogens. This could explain the increase in faecal incontinence (FI) in post-menopausal women.
Objective: To evaluate the effect of topical estrogens (TE) in controlling symptoms of FI in post menopausal women. Hypothesis: The application of TE in post menopausal women with FI improves continence. Subjects and
Methods: 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 2 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 post application respectively (p= 0,002). Wexner's FI score in group II was 12 and 9 with pre and post application 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.
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