Stool consistency over the last 3 months that includes items 1 or 7 based on the Bristol Stool form scale
Current bloody diarrhea (loose, watery stools 3 or more times a day with blood)
Current or past diagnosis of colorectal or anal malignancy
Diagnosis of inflammatory bowel disease
Current or history of rectovaginal fistula or cloacal defect
Rectal prolapse (mucosal or full thickness)
Prior removal or diversion of any portion of colon or rectum
Prior pelvic floor or abdominal radiation
Refusal or inability to provide written consent
Inability to conduct telephone interviews conducted in English or Spanish
Fecal impaction by rectal and abdominal exam
Untreated pelvic organ prolapse beyond the hymen; Patients with prolapse beyond the hymen who are currently using a pessary are eligible
Incontinence only to flatus
Has taken any loperamide (Imodium®) or diphenoxylate plus atropine (Lomotil®) in the last 30 days
Previously received and failed treatment of fecal incontinence using loperamide (Imodium®) or diphenoxylate plus atropine (Lomotil®) over the last 3 months
Current supervised anal sphincter exercise/pelvic floor muscle training with biofeedback
Previously received and failed treatment of fecal incontinence using supervised anal sphincter exercise/pelvic floor muscle training with biofeedback
Previous allergy or intolerance to loperamide
Pregnant, nursing, or planning to become pregnant before the end of the study follow-up period.
Childbirth within the last 3 months
Neurological disorders known to affect continence, including spinal cord injury, advanced multiple sclerosis or Parkinson’s disease and debilitating stroke
Known diagnosis of hepatic impairment
Chronic abdominal pain in the absence of diarrhea
Acquired Immunodeficiency Syndrome (AIDS)
Currently taking anti-retroviral drugs