Abstract

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. Method: 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 two groups: I -topical estriol, II -placebo. In both groups, the ointment was applied three times daily for a period of 6weeks. We compared Wexner's FI score and the FI quality of life scale, before commencing and after 6weeks 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). Conclusion: 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. © Journal compilation © 2009 The Association of Coloproctology of Great Britain and Ireland.