CAPABLe
Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide
Public Access Data and FormsFecal incontinence is also called accidental bowel leakage. Many women experience this very embarrassing problem which can be difficult to manage.
Doctors recommend a number of non-surgical treatments for fecal incontinence. They include:
- Changes in diet and behaviors
- Medications: Often a large number of women with fecal incontinence will complain of leaking only with loose or watery stools. Anti-diarrhea medications such as loperamide (Imodium) are at times prescribed to help create more formed stools and decrease urgent feelings of needing to go to the bathroom. Currently this medication is not prescribed routinely for women who have only fecal incontinence although it is frequently prescribed for women who complain of fecal incontinence and loose or watery stools.
- Pelvic muscle training exercises just as we use for other pelvic floor disorders.
The goal of the CAPABLE study is to learn more about the last two treatments: medications and pelvic muscle training. Specifically, this study will compare the following treatments for fecal incontinence to see if one treatment or both together are better than usual care at improving fecal incontinence:
- Loperamide only
- Pelvic muscle training only
- Loperamide and pelvic muscle training together
- Usual care / placebo pill
Women will be randomly assigned to one of the four groups above. Treatment will continue for 6 months. Women will report their symptoms throughout the study by answering questionnaires and completing a bowel diary. Recruitment began in March of 2014. The results are expected to be available in the spring of 2017.
STUDY RESULTS SUMMARY
Markland A, et al. Correlation of Digital Rectal Examination and Anorectal Manometry with Patient-Reported Outcomes Among Women with Fecal Incontinence. Int Urogynecol J. 2024 Dec.
Richter HE, et al. Characteristics Associated With Clinically Important Treatment Responses in Women Undergoing Nonsurgical Therapy for Fecal Incontinence. Am J Gastroenterol. 2020 Jan.
Jelovsek JE, et al. Controlling faecal incontinence in women by performing anal exercises with biofeedback or loperamide: a randomised clinical trial. Lancet Gastroenterol Hepatol. 2019 Sep.
Markland AD, et al. Improving biofeedback for the treatment of fecal incontinence in women: implementation of a standardized multi-site manometric biofeedback protocol. Neurogastroenterol Motil. 2017 Jan.
Jelovsek J Eric, et al. Controlling anal incontinence in women by performing anal exercises with biofeedback or loperamide (CAPABLe) trial: Design and methods. Contemp Clin Trials. 2015 Sep.