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      An Open-Label, Noncomparative, Multicenter Study to Evaluate Efficacy and Safety of NASHA/Dx Gel as a Bulking Agent for the Treatment of Fecal Incontinence

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          Abstract

          Fecal incontinence (FI) is the involuntary loss of rectal contents through the anal canal. Reports of its prevalence vary from 1–21%. Studies, have demonstrated a positive effect on FI symptoms with injectable bulking agents. This study evaluated the safety and efficacy of NASHA/Dx gel in the treatment of FI. One hundred fifteen eligible patients suffering from FI received 4 injections of 1 mL NASHA/Dx gel. Primary efficacy was based on data from 86 patients that completed the study. This study demonstrated a ≥50% reduction from baseline in the number of FI episodes in 57.1% of patients at 6 months, and 64.0% at 12 months. Significant improvements ( P < .001) were also noted in total number of both solid and loose FI episodes, FI free days, CCFIS, and FIQL scores in all 4 domains. The majority of the treatment related AEs (94.9%) were mild or moderate intensity, and (98.7%) of AEs resolved spontaneously, or following treatment, without sequelae. Results of this study indicate NASHA/Dx gel was efficacious in the treatment of FI. Treatment effect was significant both in reduction of number of FI episodes and disease specific quality of life at 6 months and lasted up to 12 months after treatment.

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          World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.

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            Fecal incontinence quality of life scale

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              Community-based prevalence of anal incontinence.

              To determine the prevalence of and characteristics associated with anal incontinence in the general community. Community survey. The population of the state of Wisconsin sampled in the Wisconsin Family Health Survey. Subjects were identified by random digit dialing with telephone interview. The individual within each household identified as most knowledgeable about the health status of all other members of the household was asked about the health status of each member of the household. Approximately 200 households were surveyed each month. The presence of anal incontinence to solid or liquid feces or gas, who suffered from it, the frequency of anal incontinence, and how the incontinent person coped with it. A total of 2570 households comprising 6959 individuals were surveyed, and 153 individuals were reported to have anal incontinence, representing 2.2% of the population (95% confidence interval [Cl], +/- 0.3%). Thirty percent of the incontinent subjects were older than 65 years, and 63% were women. Of those with anal incontinence, 36% were incontinent to solid feces, 54% to liquid feces, and 60% to gas. In a multivariate analysis, independent associations of the following risk factors with anal incontinence were found: female sex (odds ratio [OR], 1.5; Cl, 1.1 to 2.1), age (continuously adjusted) (OR, 1.01; Cl, 1.01 to 1.02), physical limitations (OR, 1.8; Cl, 1.2 to 2.7), and poor general health (OR, 1.6; Cl, 1.4 to 1.9). Anal incontinence was reported in 2.2% of the general population. Independent risk factors for incontinence include female sex, advancing age, poor general health, and physical limitations.
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                Author and article information

                Journal
                Gastroenterol Res Pract
                GRP
                Gastroenterology Research and Practice
                Hindawi Publishing Corporation
                1687-6121
                1687-630X
                2010
                27 December 2010
                : 2010
                : 467136
                Affiliations
                1Università degli Studi di Padova Hospital Clinica Chirurgica, Via Giustiniani 2, 35128 Padova, Italy
                2Proktologische Praxis Kiel, Beselerallee 67, 24105 Kiel, Germany
                3Coloproctology Section, Department of Surgery, Virgen del Rocio University Hospital, Avenida Manuel Siurot s/n, 41013 .Seville, Spain
                4St. Paul's Hospital, C313-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6
                5Coloproctological Unit of Bari Policinico di Bari Piazza, University of Bari, Giulio Cesare 11, 70124 Bari, Italy
                6Clinique Chirurgicale, chu-Hôtel-Dieu, Institut des Maladies de l'Appareil Digestif, 1 Place Alexis Ricordeau, 44093 Nantes Cedex, France
                Author notes

                Academic Editor: Y. Yamaoka

                Article
                10.1155/2010/467136
                3017894
                21234379
                55d7d16b-7572-4f25-baea-060336072a5b
                Copyright © 2010 Giuseppe Dodi et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 June 2010
                : 1 October 2010
                : 4 November 2010
                Categories
                Research Article

                Gastroenterology & Hepatology
                Gastroenterology & Hepatology

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