Bowel incontinence

A 59-year-old woman received 5% hjq)erbaric Udocaine 60 mg for an operation on a toe. That evening she complained of urinary and bowel incontinence 5 months later she had urinary stress incontinence and bowel incontinence, with absent anal reflexes. There was also reduced sensation over the medial side of the foot. 

Stimulation of 5-HT3 receptors triggers hypersensitivity and hyperactivity of the large intestine. Alosetron (Lotronex) is a selective 5-HT3 antagonist that blocks these receptors and is used to treat women with severe diarrhea-predominant IBS. Eligible patients should have frequent and severe abdominal pain, frequent bowel urgency or incontinence, and restricted daily activities. Alosetron has been shown to improve overall symptoms and quality of life. Alosetron can cause constipation in some patients. 

Bowel symptoms in MS patients can include both fecal incontinence and constipation. Fecal incontinence is difficult to treat. Some patients may have improvement if they use a regular schedule for emptying the bowel with laxative suppositories or enemas. Alternatively, antidiarrheal medications such as loperamide can be used.14... 

The effect of orlistat in adolescent patients has been evaluated recently. In a group of 12- to 16-year-old individuals, orlistat (120 mg three times daily) in combination with diet, exercise, and behavior modification exhibited minimal weight increase after 1 year (0.53 kg) compared with placebo-treated patients (3.14 kg). Common adverse reactions observed were fatty or oily stools, oily spotting, oily evacuation, or abdominal pain and/or flatulence with bowel movements. Soft stools, nausea, increased defecation, and fecal incontinence also were noted. Orlistat may be better suited for prevention of weight gain in tolerant adolescents, but more studies are warranted before providing a solid recommendation.36... 

Coma tncrease/decrease Pinpoint Hypersalivation, bradycardia, muscle fasciculation and tremors, hyperactive bowel sounds, diarrhea and urinary incontinence sometimes with smell of petroleum distillates (solvent) Organophosphate pesticides... 

CNS Bowel Dysfunction Bladder Dysfunction [S Falls Other Orthostatic Hypotension, Worsening of urge or mixed urinary incontinence... 

Neurokinins comprise a group of peptides involved in nerve transmission. Specific members of this class of mediators control such diverse functions as visceral regulation and CNS function. The nonpeptide neurokinin antagonist talnetant (32-6), for example, has been evaluated for its effect on irritable bowel syndrome and urinary incontinence as well as depression and schizophrenia [36]. The quinoline portion of this compound is prepared by base-catalyzed Pfitzinger condensation of isatin (32-1) with the methoxy acetophenone (32-2). The methoxy ether in the product (32-3) is next cleaved by means of hydrogen bromide (32-4). Amide formation with the chiral a-phenylpropylamine (32-5) affords the neurokinin antagonist talnetant (32-6) [37]. 

Propantheline Pro-Banthine Peptic ulcer, irritable bowel syndrome, urinary incontinence... 

DWI promises to have tremendous value in accurately localizing the subcortical or brainstem lesion(s). A summary of studies of DWI in patients with lacunar stroke is provided in Table 13.2. It is noteworthy that there is also a group of patients with lacunar infarction who harbor multiple chronic white matter lesions on the conventional MRI and present with non-specific syndromes that could not be attributed to a specific arterial territory. Such symptoms include worsening of a preexisting dysarthria, dysphagia or ataxia, sudden appearance of emotional incontinence or recent onset bowel or bladder problems. Excellent diagnostic performance of DWI in lacunar infarctions may help to prove ischemia as the cause of non-specific neurological symptoms in such patients. 

A 71-year-old woman developed lithium toxicity (serum concentration 2.1 mmol/l) because of increased absorption of urinary lithium from the bowel following urinary diversion with ileal conduits for stress incontinence (547). 

Surgery for colon cancer generally involves complete tumor resection with an appropriate margin of tumor-free bowel and a regional lymphadenectomy. Surgery for rectal cancer depends on the area involved. Although less than 33% of these patients require permanent colostomy, frequent complications include urinary retention, incontinence, impotence, andlocoregional recurrence. 

Atropine is used in the management of sinus bradycardia with hemodynamic instability and in the treatment of peptic ulcer disease, irritable bowel syndrome, urinary incontinence, and organophos-phate and carbamate poisoning. It is also present in ophthalmic preparations to induce mydriasis and cyclopegia. Atropine is often administered preope-ratively to decrease secretions. 

Smoking cessation for patients with cough-induced stress incontinence weight reduction for obese patients with stress incontinence good bowel hygiene for patients with constipation caffeine reduction, selected dietary and fluid modifications for patients with urge incontinence (e.g., eliminate aspartame, spicy foods, citrus fruits, carbonated beverages)... 

A 68-yr-old man drank pokeweed tea as a treatment for constipation. He experienced a loose bowel movement, diaphoresis, confusion, tremor, muscle weakness, salivation, vomiting, urinary incontinence and syncope (Jaeckle and Freemon, 1981). He became unconscious for 10 or 15 min. Breathing was deep and rapid at 22 breaths per minute. After arrival at the hospital his blood pressure increased from 74/54 mm Hg to 120/80 mm Hg over the course of an hour. 

The possibility of increasingly efficacious muscarinic therapeutic agents greatly depends on a sound knowledge of the functional role of the multiple muscarinic receptors expressed in the brain and in the periphery. In fact, many diseases including Alzheimer and Parkinson s, urinary incontinence, irritable bowel syndrome, and chronic obstruc-... 

The child s mother called the pohce, who took Katta to the hospital emergency room. The patient was semicomatose, incontinent of urine, and her clothes were stained with vomitus. She had a fever of 103°F, was trembling uncontrollably, appeared to be severely dehydrated, and had marked muscle wasting. Her heart rate was very rapid, and her blood pressure was low (85/46 mm Hg). Her abdomen was distended and without bowel sounds. She responded to moderate pressure on her abdomen with moaning and grimacing. 

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