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Volume 9, No 4 - Fall 2009

Volume 9, No 4 - Fall 2009

Table of Contents

Prevalence and Risk Factors of Fecal Incontinence in Community-Dwelling Men Systematic Review
Fecal incontinence (FI) in community-dwelling men affects quality of life and increases the risk of institutionalization. Observational studies and randomized, controlled trials (RCTs) on epidemiology and prevention of FI published in English from 1990 to November 2007 were identified in several databases to abstract rates and adjusted odds ratios (ORs) of incontinence and to synthesize evidence with random effects models. Twenty-one observational studies and 4 RCTs were eligible for analysis. Pooled prevalence of FI in elderly men increased with age to 5% to 6%. Men over age 85 years (OR 2.5; 95% confidence interval [CI], 1.3-5) and with kidney diseases (OR 1.9; 95% CI, 1.2-3.3) had higher odds of incident FI. Significantly impaired cognitive status and general health were associated with FI. Men had increased risk of incontinence after radical prostatectomy or radiation for prostate cancer. Lower doses of radiation caused inconsistent reduction in FI across 2 RCTs. The prevalence of incontinence increased with age and functional dependency. Cognitive impairment, poor general health, surgery, and radiation for prostate cancer were associated with incontinence in community-dwelling men. No effective interventions are known at the present time. [Rev Gastroenterol Disord. 2009;9(4):E97-E110 doi: 10.3909/rigd0353a]© 2009 MedReviews®, LLC
Peptic Ulcer Bleeding Following Therapeutic Endoscopy: A New Indication for Intravenous Esomeprazole Drug Review
Intravenous (IV) administration of the esomeprazole is a faster way to achieve gastric acid suppression than oral administration of the same agent. Peak suppression following IV administration occurs within hours compared with several days following oraladministration. Thus, the IV administration route offers a faster onset of gastric suppression, achievement of intragastric pH closer to target levels, and better bioavailability. Treatment of peptic ulcer bleeding is the newest indication for the IV formulation of esomeprazole. The drug is effective in preventing rebleeds following endoscopic treatment when administered within 24 hours of the procedure as an 80-mg bolus followed by an IV infusion for 72 hours. What remains to be seen is whether oral therapy can be substituted for all, or part, of the 72-hour IV infusion and whether the patient can be discharged from the hospital sooner with similar outcomes.[Rev Gastroenterol Disord. 2009;9(4):E111-E118 doi: 10.3909/rigd0349]© 2009 MedReviews®, LLC
Novel Transdermal Patch Vaccine to Prevent Travelers’ Diarrhea Diarrhea
[Rev Gastroenterol Disord. 2009;9(4):E119-E120 doi: 10.3909/rigd0349]© 2009 MedReviews®, LLC