Other Pharmacological Agents

Discussion

For people with SCI, other pharmacological agents such as oxymetazoline and lidocaine have been examined in bowel care through little research. Oxymetazoline, an alpha agonist, increased resting anal pressure and decreased the number of fecal incontinence episodes in one small crossover RCT (Barak et al. 2019). Another small clinical trial found that lidocaine lubricant (xylocaine 2%) increased bowel care duration and worsened autonomic dysreflexia, so authors cautioned against this procedure unless people were under medical supervision (Lucci et al. 2020).

Conclusion

There is level 1 evidence from one crossover RCT that (Barak et al. 2019) that the α-agonist oxymetazoline 1.0% increases resting anal pressure and decreases fecal incontinence episodes.

There is level 2 evidence from one clinical trial (Lucci et al. 2020) that found lidocaine lubricant (xylocaine 2%) increases bowel care duration and worsened autonomic dysreflexia.