Other Pharmacological Agents

There have been a few studies examining other pharmacological agents, such as oxymetazoline and lidocaine, and their effects on bowel care in people with SCI. 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.