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Bulking agent reduces faecal incontinence

By Christian Duffin

Injecting a bulking agent into the anal canal improves symptoms of faecal incontinence when compared to a sham placebo, according to the first controlled trial to show that this treatment is effective.

Researchers randomly assigned 206 patients aged 18 to 75 from the USA and Europe to receive either four injections of 1 ml of dextranomer in stabilised hyaluronic acid in the anal canal, or sham treatment. Patients in the active group received a maximum of 8ml over a year.

The researchers found that, after six months, 52% of the dextranomer patients had a 50% or more reduction in the number of incontinence episodes, compared with 31% who received the sham treatment.

Dr Wilhelm Graf, a researcher in the department of surgery at Akademiska sjukhuset, Uppsala, Sweden, concluded: ‘This treatment is easy to apply and safe and might be used as a treatment before more invasive techniques or as an additional or adjuvant treatment if other treatments do not give adequate symptomatic relief.

‘A refinement of selection criteria for patients, optimum injected dose, ideal site of injection, and long-term results might further increase the acceptance of this minimally invasive treatment.'

The Lancet Volume 377 Issue 9770 Pages 997 - 1003

Bulking agent reduces faecal incontinence

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