Fecal incontinence

Evaluate 5-HT3 receptor antagonists (alosetron) for relief of abdominal pain and fecal incontinence. 

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... 

Pelvic floor disease prior gynecologic surgery, hormonal status (pre- vs. postmenopausal) Constipation, diarrhea, fecal incontinence,... 

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... 

The safety and efficacy of orlistat have not been determined beyond 4 years of use. Minimal systemic effects exist because orlistat acts locally in the GI tract. Thus, common side effects reported include oily spotting, flatus with discharge, fecal urgency, fatty/oily stools, oily evacuation, increased defecation, and fecal incontinence.31 Other adverse events include bloating, abdominal pain, dyspepsia, nausea, vomiting, diarrhea, and headache.37... 

Smooth muscle Bronchial Gastrointestinal wall Sphincter Contraction Contraction Relaxation Bronchoconstriction Vomiting, cramps, diarrhea Fecal incontinence... 

Symptoms develop rapidly over 24 to 72 hours and include body temperature exceeding 38°C (100.4°F), altered level of consciousness, autonomic dysfunction (tachycardia, labile blood pressure, diaphoresis, tachypnea, urinary or fecal incontinence), and rigidity. 

Symptoms Soman exposure results in pupil constriction, blurred and dimmed vision, pain in the eyeballs chest tightness, difficulty in breathing sweating, salivation, increased bronchial secretions, bradycardia, hypotension, vomiting and diarrhea, bronchoconstric-tion, and urinary and fecal incontinence. 

However, dietary fat consumed has got to go somewhere. If it is not absorbed, then it must traverse the gut and be excreted in the feces. Here the net effect is to increase the level of fat and oil in the feces and the result is not difhcult to guess. About half of the people on orlistat have a problem with fecal incontinence and underwear soiling. There is a price to pay for orlistat-assisted weight loss. 

Gl Oily spotting flatus with discharge fecal urgency fatty/oily stool oily evacuation increased defecation fecal incontinence. 

Anaphylactic response. Seed oil, administered periodontally to adults, was effective. A 46-year-old male developed recurrent reaction to sesame seed oil. The symptoms were chills, shakiness, cramps, vomiting, fecal incontinence, fainting, flushing, and pruritic welts. Skin test revealed a four-plus multitest response and a marginally positive rast. Significant histamine release was also... 

Paresthesias, weakness and paralysis of lower extremity, hypotension, high or total spinal block, urinary retention or incontinence, fecal incontinence, headache, back pain, septic meningitis, meningismus, arachnoiditis, shivering cranial nerve palsies due to traction on nerves from loss of CSF, and loss of perineal sensation and sexual function Rare... 

Toxicity GI Flatulence, steatorrhea, fecal incontinence Cardiovascular Tachycardia, hypertension CNS Depression, anxiety, nausea... 

When repaglinide 4 mg tds and glimepiride 160 mg bd were used in combination with bedtime NPH insulin for 13 weeks in 80 patients, one patient had severe diarrhea and fecal incontinence which subsided after stopping repaglinide (50). 

Olanzapine-induced fecal incontinence has been reported (228). 

A 65-year-old man who had had primary insomnia for 20 years, was given olanzapine 2.5 mg/day at nighttime because of lack of response to various anxiolytics he developed fecal incontinence during the 20 days of olanzapine treatment in combination with two anxiolytic drugs. The frequency of incontinence varied from 1 to 3 times a day, and withdrawal of olanzapine resulted in complete recovery. 

Mendhekar DN, Srivastav PK, Sarin SK, Jiloha RC. A case report of olanzapine-induced fecal incontinence. J Clin Psychiatry 2003 64 339. 

Stage 4 (end stage) Nearly vegetative. Intellectual and social com prehension and ouq>ut are at a rudimentary level. Nearly or absolutely mute. Paraparetic or paraplegic with urinary and fecal incontinence... 

A 45-year-old woman with resistant rheumatoid arthritis was given etanercept 25 mg twice weekly. Nine days later she developed total acute sensory loss, with flaccid paraplegia, fecal incontinence, and urinary retention. MRI imaging and cerebrospinal fluid analysis were consistent with a diagnosis of transverse myelitis. She also had positive antinuclear and anticardiohpin antibodies. After etanercept withdrawal and treatment with dexa-methasone and cyclophosphamide, her motor function improved with no change in sensory function. 

Romero Y, Evans J, Fleming KC, Phillips SE. Constipation and fecal incontinence in the elderly population. Mayo CUn Proc 1996 71 81-92. 

Ko CY, Tong J, Lehman RE, et al. Biofeedback is effective for fecal incontinence and constipation. Arch Surg 1997 132 829-833. 

In the elderly, the ratio of bacteriuria in women and men is dramatically altered and is approximately equal in persons over the age of 65. ° The overall incidence of UTI increases substantially in this population, with the majority of infections being asymptomatic. The rate of infection increases further for elderly persons who are residing in nursing homes, particularly those who are hospitalized frequently. The increase is probably the result of a number of factors, including obstruction from prostatic hypertrophy in males, poor bladder emptying as a result of prolapse in females, fecal incontinence in demented patients, neuromuscular disease, including strokes, and increased urinary instrumentation (catheterization). 

Gastrointestinal Nausea, vomiting, abdominal pain, diarrhea, fecal incontinence, tenesmus, anorexia, abdominal tightness Glands Same if chronically exposed... 

---