Talk:Fecal incontinence

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First person speech[edit]

This article contains a lot of speech in the first person (you, yourself, etc). I have fixed some of those parts, but there is still some work missing. Rbarreira 20:00, 11 December 2005 (UTC)

I did not notice any remaining first person speech, so I removed the notice. --Driscoll 20:20, 26 August 2007 (UTC)

Dietary[edit]

The following text is deleted from the article because of tone of the refnotes and because if those belong on wikipedia at all then they belong on pages more specific to the products in question. --Una Smith (talk) 15:20, 12 January 2008 (UTC)

Fecal incontinence is also a potential side-effect of medicines that prevent the absorption of dietary fats such as Orlistat and can also be caused by eating non-digestible oils or fats such as Olestra. [1] [2] [3] [4]

Alcoholism (severe cases)[edit]

This may also lead to F. I. (well, it's an open secret). Only thing I do not get is why this article doesn't mention alcohol in any way; of course, you can read "drugs" but most people would not call alcohol a "drug." I agree that it may be included into the "drugs" group; yet for the sake of clarity and readability, alcohol ought to be mentioned separately IMHO. -andy 77.190.52.185 (talk) 00:27, 8 May 2011 (UTC)

evidence source? tepi (talk) 03:09, 9 October 2012 (UTC)
I think this might be more to do with loss of consciousness and reduced alertness than anything else...Lesion (talk) 11:34, 1 February 2013 (UTC)

Definition in need of reworking?[edit]

This article's definition could be interpreted as vague and imprecise. E.g. what does regular control of the bowels mean? A patient could have irregular bowels without being incontinent. Whether there is a voluntary control or not is the key factor, and we should make this clear. Rather than involuntary excretion or leaking (whats the difference?) being common features, they are the defining features imo. Some other definitions I have read of FI I feel are better:

"the inability to control feces and to expel it at a proper place and at a proper time" "the inability to prevent involuntary loss of bowel content" "recurrent uncontrolled passage of fecal material in an individual with a developmental age of at least 4 years" tepi (talk) 19:19, 1 October 2012 (UTC)

Innapropriate/misleading language regarding risk of FI with anoreceptive intercourse?[edit]

Currently the article reads: "Another study among forty anoreceptive homosexual men and ten non-anoreceptive heterosexual men found a very significant increase in fecal incontinence (fourteen, or 35% amongst the anoreceptive men, and one, or 10% in the non-anoreceptive sample) amongst the anoreceptive sample.[12]"

Upon reading the study, "This study has revealed an excess of minor anal incontinence amongst anoreceptive homosexual men. Over a third of AR subjects reported some degree of anal incontinence or urgency of defaecation."

I feel the wording "very significant" is misleading. Either something is statistically significant or it is not. Furthermore, this is a very small cohort study and therefore its findings need considered with that in mind. tepi (talk) 19:51, 2 October 2012 (UTC)

These 2 studies are in the false order. First is 1993. There is lower maximal pressure within AR and for all with incontinence. 1997 shows only lower standard pressure with AR, the maximum pressure is not lower. Also he looked with ultrasonic and find no demage. So he write the lower pressure is from acclimatization. (sorry for my bad englisch) --Franz (Fg68at) de:Talk 02:29, 9 October 2012 (UTC)

Apart from changing the order in which the studies are mentioned, how else to improve the wording in the article? The acclimatization refers to physiological muscular acclimatisation to anorectal manipulation or a psychological difference in the way the groups reacted to manometry? tepi (talk) 03:09, 9 October 2012 (UTC)

Existing issues...[edit]

  • surgical options need to be covered in full
  • puborectalis sling diagram is poor, inaccurate as puborectalis is in continuity with the EAS in reality...anal canal shape is also weird...sphincters do not extend full length and not a uniform width tube.
  • the subtypes of FI termed anal incontinence and fecal leakage were originally intended to be articles intheir own right, however I felt it was best to integrate them here in the end. This has lead to some repatition in etiology and treatment...maybe needs some work?
  • is this page now too long?

p = 0.05 (talk) 00:03, 5 November 2012 (UTC)

I alerted WP:MED that this article needs their help.[1] 108.60.139.170 (talk) 01:23, 10 November 2012 (UTC)
TY for help. I already checked on that project for any colorectal surgeons, unfortunately none. I will probably sort out the remainder of the issues myself soon, but any edits welcome, the list was more of an active to do list tbh. lesion (talk) 12:19, 10 November 2012 (UTC)
Confusion caused by the puborectalis sling diagram was raised during the PR...need new diagram? Article possibly now too long (not mentioned in PR). Apart from that, surgical options each have own section, and "types" section now merged into main sections. Ready for WP:GAN imo. lesion (talk) 23:07, 9 December 2012 (UTC)

GA Review[edit]

This review is transcluded from Talk:Fecal incontinence/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Jmh649 (talk · contribs) 18:19, 14 December 2012 (UTC)

Status = NOT LISTED AS GA[edit]

Review of all sources now complete, notes are in the Sources table. Plan to go over article prose again over next few. Also, Tepi, instead of only making notes here on the GA review page I have also made notes in-article about things that need sources, etc. Zad68 03:53, 13 March 2013 (UTC)

Tepi - Commenting on sourcing fixes tonight, a little more copyediting; stuff to work on still! Zad68 02:29, 19 March 2013 (UTC)

Tepi and I had a discussion and we are in agreement not to list the article for GA at this time. It's come quite a good way towards GA, but there's still some work to do and Tepi will keep working on it in his own time. Zad68 03:48, 21 March 2013 (UTC)

More from Biosthmors[edit]
  • Yeah I've been mulling that over in my mind... I generally like "backgrounder" information, especially in a general encyclopedia not targeted specifically to a medical audience, but that section is really very large. I was considering asking for it to be cut down by quite a bit. It might make a useful addition to another article. Unless you can think of another place where it could go here in this article? Zad68 00:55, 6 February 2013 (UTC)
  • It is maybe excessive detail when we could just nest defecation for this subsection? Much of the content is about defecation generally, rather than continence, if that makes sense. Lesion (talk) 01:45, 6 February 2013 (UTC)
  • Tepi can you consider, for this article, cutting down that large discussion into like maybe 3-4 sentences of backgrounder? Pull just the information most relevant to the causes of FI. But that was a lot of good work you put into that section, see if there's another article you can merge it into. Adding -- defecation is in terrible shape, please use the content you developed here in that article, it would really help it. Zad68 04:10, 6 February 2013 (UTC)
  • Reduced to paragraph length...probably I can reduce it some more later. Lesion (talk)

GA table[edit]

Rate Attribute Review Comment
1. Well-written:
1a. the prose is clear and concise, it respects copyright laws, and the spelling and grammar are correct. Close paraphrase issue, verifiability issue Could be made more clear
1b. it complies with the manual of style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.
2. Verifiable with no original research:
2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline. References section exists
2b. it provides in-line citations from reliable sources for direct quotations, statistics, published opinion, counter-intuitive or controversial statements that are challenged or likely to be challenged, and contentious material relating to living persons—science-based articles should follow the scientific citation guidelines. Will need a review after the sourcing issues noted in the sources table are remedied
2c. it contains no original research. Some areas where article content should be double-checked against sources.
3. Broad in its coverage:
3a. it addresses the main aspects of the topic.
3b. it stays focused on the topic without going into unnecessary detail (see summary style).
4. Neutral: it represents viewpoints fairly and without bias, giving due weight to each.
5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.
6. Illustrated, if possible, by images:
6a. images are tagged with their copyright status, and valid fair use rationales are provided for non-free content.
6b. images are relevant to the topic, and have suitable captions. Infobox image is normal function and does not depict FI, I know you're working on getting permission for a FI one, but the one that's there is adequate
7. Overall assessment. Not listed for GA at this time while Tepi continues work on it

Notes[edit]

Note -- the number in parentheses before each item corresponds with the numbering of the GA requirement listed in the GA Table above.

MOS compliance[edit]

  • (1b) Duplicate links: trauma(tically), rectal discharge, fistulae, obstetric, fistulotomy, anal fistula, rectal prolapse, obstructed defecation, IBS, fecal loading, stroke, MS, dementia, SSRI, antacids, trycyclic antidepressants, piles, abnormal perineal descent, Pudendal nerve terminal motor latency, Endoanal ultrasound, functional, laxative, olestra, loperamide, impaction, dyanmic graciloplasty, sphincterotomy, fistulotomy, hemorrhoidectomy, low anterior rectal resection, colectomy
fixed... Lesion (talk) 14:29, 30 January 2013 (UTC)

General[edit]

  • Avoid doing things like "symptom(s)" when you mean "symptom or symptoms", it's not encyclopedic, you can generally just use the plural.
Yes check.svg Done

Lead[edit]

  • (1a) FI is not untreatable and almost all people can be helped. -- consider: FI is generally treatable.
Yes check.svg Done
  • (1) Lead currently appears unbalanced, as there is too much about the social stigma relative to the proportion of coverage of this in the article.
Removed sent "Topics relating to feces are taboo" or something, wasn't contributing much.
  • (1) Lead should be 3-4 paragraphs, reorganize
Yes check.svg Done
  • (1) "which is described as devastating" -- if you semi-quote something here (which is described as... who is describing?) you have to name where it's coming from. But, "devastating" is an emotive rather than informative word, can you describe in exactly what ways it is devastating?
It was from Yamada's Textbook of Gastroenterology, p1728 "Unfortunately, physicians may not always appreciate the devastating consequences of FI because patients are often embarrassed to discuss their symptoms." Removed devastating and replaced with less emotive description from society and culture section "one of the most psychologically and socially debilitating conditions in an otherwise healthy individual". Lesion (talk) 14:53, 30 January 2013 (UTC)
  • (1) FI is generally treatable.[2] There are many different treatments available and management is related to the specific cause(s). Management may be an individualized mix of dietary, pharmacologic and surgical measures. It has been suggested that health care professionals are often poorly informed about treatment options.[2] They may fail to recognize the impact of FI, which is described as one of the most psychologically and socially debilitating conditions in an otherwise healthy individual.[3] -- consider replacing this whole lead paragraph with: FI is one of the most psychologically and socially debilitating conditions in an otherwise healthy individual, but it is generally treatable. Management can be achieved through an individualized mix of dietary, pharmacologic and surgical measures. Health care professionals are often poorly informed about treatment options, and may fail to recognize the impact of FI.
Yes check.svg Done

Definition[edit]

  • Can you combine the five separate definitions into one general one, something like, "Fecal incontience is generally defined as the inability to voluntarily control the passage of bowel contents through the anal canal and expel it at a socially acceptable location and time." I think it'd be better to combine the imporatant features common to the definitions rather than to just give an unorganized list.
  • FI can be divided into those people who experience a defecation urge before leakage, termed urge incontinence, and those who experience no sensation before leakage, termed passive incontinence or soiling. -- I can't find this in the cited NICE source, I don't see "urge incontinence" in the text at all, can you help me find this? ... oh wait maybe I have to search for "urge faecal incontinence"
p.29 Lesion (talk) 15:17, 30 January 2013 (UTC)
  • It has been suggested that once continence to flatus is lost, it is rarely restored. -- Why "it has been suggested", can you just say "Once continence to flatus is lost..."? Why not if not?
reworded, but not particularly able to explain why since our source does not either ... "Identification of which symptoms trouble the patient and what can be achieved by repair is essential. Thus continence to flatus can rarely be restored once lost and dietary modification with medication may be more helpful."
  • Fecal leakage is a related topic to rectal discharge... fecal mass to be retained in the rectum. -- Is this whole part still on the topic of FI?
Having studied both FI and rectal discharge a little bit, I feel there is some overlap here and a link to the (currently poor) rectal discharge page is necessary. E.g. both topics tend to list lesions that mechanically prevent anal canal closure, such as fissures. With regards "fecal leakage" this is a subtype of FI...
  • Several severity scales have been suggested. the most commonly used are mentioned below. -- can you just get rid of "the most commonly used are mentioned below.", again "below" isn't desired
Yes check.svg Done
  • over the age of 4 -- 4 should be spelled out "four" here per WP:MOSNUM
Yes check.svg Done
  • (+/- urgency) -- do you mean "with or without"? Use words
Yes check.svg Done
  • The Park's incontinence score uses 4 categories, -- it says 4 here but then goes on to list 6 things; 4 --> "four"
Yes check.svg Done I can see why you thought this, it was v confusing before, reworded now.
  • This Severity scales section is confusing and needs clarifying
Yes check.svg Done
  • Other severity scales include... -- how common are the Wexner and Park's scales relative to all these others?
Kaiser and the ASCRS textbook seem to suggest that are more commonly used than those listed at the end of the section.
  • Requested citation for "Solid stool incontinence may be called complete (or major) incontinence, and anything less as partial (or minor) incontinence" partially supported by ASCRS textbook, p.653 "Partial incontinence may be defined as uncontrolled passage of gas and/or liquids and complete incontinence as the uncontrolled passage of solid feces." Yes check.svg Done Lesion (talk) 15:42, 17 February 2013 (UTC)

Differential diagnosis[edit]

  • symptoms(s) --> symptoms
Yes check.svg Done
  • "prtorusion" -- is protrusion meant?
Yes check.svg Done
  • If there is a major underlying cause, this may also give rise to specific signs and symptoms in addition to the ones above (e.g. prtorusion of mucosa in external rectal prolapse). -- avoid using page-relative directions like "to the ones above"; consider rewording this as, Any major underlying cause will produce additional signs and symptoms, such as protrusion of mucosa in external rectal prolapse.
Yes check.svg Done
  • (1a) Possible close paraphrase/plagiarism problem:
Source = Focal defects (e.g. keyhole deformity after previous anorectal surgery) can therefore result in significant symptoms despite a seemingly normal pressure profile.
Article = Focal defects (e.g. keyhole deformity) can therefore result in significant symptoms despite a seemingly normal anal canal pressures.
Reword "This means that even with normal anal canal pressure, focal defects such as the keyhole deformity can be the cause of substantial symptoms"
  • (1a) FI (and urinary incontinence) may also occur during seizures. -- sourced to Kaiser but can't find "seizures" in the source.
Added supporting citation for FI during seizure.
  • (1a) Nontraumatic conditions interfering with anal canal function include scleroderma... - the source is more specific and says these are causes of anal sphincter weakness, can this be made more specific?
Reword "Nontraumatic conditions which may cause anal sphincter weakness include scleroderma ..." Lesion (talk) 13:52, 30 January 2013 (UTC)

Pathophysiology[edit]

  • (1b) Some believe the anorectal angle is one of the most important contributors to continence. -- "Some believe" is WP:WEASEL. I'm not quite seeing this in the source... it talks about the angle but I'm not seeing it stating "one of the most important important contributors", can you help me find where it says this?
Couldn't find it. Upon rereading parts of The ASCRS textbook, it seems that opinions are divided as to how important the anorectal angle is in continence. Removed this sentence.Lesion (talk) 14:09, 30 January 2013 (UTC)

Diagnostic approach[edit]

Please could you go into more detail about the undue tag on the functional FI section and the comment in the sourcing table about the Rome criteria ref not being notable? Lesion (talk) 13:42, 14 March 2013 (UTC)

Basically my question is: Is "Rome" all that overwhelmingly important and essential to the general topic of FI that it deserves its own section in the article? Is it like the undisputed international standards group regarding the condition? In reviewing the sources I did not get the impression that it was. Zad68 21:13, 14 March 2013 (UTC)
I think functional causes should be discussed (and is already in the article in the causes section, just not in its own section). According to that UK NICE guidelines doc, "Irritable bowel syndrome" is one of the 9 main subtypes (another is idiopathic cases), and some of the other subtypes could have functional causes too (e.g. fecal loading). This section that is tagged with undue is in the "diagnostic approach" part of the article, and therefore should only include that kind of info... Rome process is fairly authoritative on internationally agreed diagnostic criteria, mostly for research purposes (my impression), and so is potentially a good source to include. Considering that functional causes of FI are notable to discuss in the causes section, I feel it would be good to include this precise set of diagnostic criteria for functional FI. Would it seem less undue without its own section? i.e. it could be merged with the rest of the parent section? Lesion (talk) 21:59, 14 March 2013 (UTC)
I will look. Agree Rome is a good source, but my WP:UNDUE concern was, they appear to be the only ones talking about "Functional FI", they have their 'own section'. Does nobody else cover Functional FI? Zad68 03:42, 15 March 2013 (UTC)
Other functional causes/exacerbating factors for FI like IBS and anismus are discussed already in the article's other sections. My understanding is that you want the term "functional" to be supported by another source? This should not be hard to find, but it would probably go to source content in the "causes" section rather than this diagnostic approach section... Lesion (talk) 19:41, 15 March 2013 (UTC)
Ok I added a fairly recent review which stated that "functional FI is a common symptom..." Lesion (talk) 02:01, 16 March 2013 (UTC)

Treatment[edit]

  • (1a) Table - four blank lines under Solid, should these cells be merged?
I'll find out how to do this...
Yes check.svg Done
  • Other measures - Doc's concern about too much content regarding pelvic floor exercises
this issue was resolved and the section rewritten?
  • (1a) Dietary modification may be central to successful management -- "may be central": "may be" is a hedge, "central" is emphatic, and together they clash. For which people is it central? Qualify
This sent used to read "some believe that dietary modificiation is central..." but this was weasel... I could change central -> important.
  • A surgical treatment algorithm has been proposed. -- Is this just Wexner's own proposal? Has this proposal been endorsed or mentioned anywhere else? If it's just Wexner's idea and isn't generally accepted, and Wexner isn't a particularly notable leader in the field, it's probably undue to mention it.
This is based on the diagram on p 116 of "Coloproctology". The text refers to the diagram with "Depending on the underlying condition, various surgical treatment modalities can be offered and a new treatment alogrithm has evolved (Fig. 9.1)." with no reference. Even if it was just Wexner's idea, I think there is an eponymous severity scale, so maybe they are a notable person. This reads badly due to conversion from list to prose, and may be out of date since it does not include some options. Does it contribute significantly to warrant inclusion? Lesion (talk) 15:11, 30 January 2013 (UTC)
  • (1a) Symptoms may worsen over time, but is not untreatable and almost all people are helped with conservative management, surgery or both. -- I thought FI itself was a symptom, can a symptom have symptoms? also verb agreement and double-negative, I do not see how "worsen over time" is connected to "treaments and management are available", and the wording here sounds vaguely non-encyclopedic and more "So you have fecal incontinence" brochure; consider something like: FI may worsen over time. Conservative management strategies and surgical treatments are effective and have high rates of success.
Um... as per WP:MEDMOS#Symptoms or signs it is not recommended to have a section called "signs and symptoms". This section was largely taken from the section "symptoms" on Kaiser. I don't really think this is a problem, but it could potentially be merged with classification by symptom ? I think worsen over time refers to the symptom worsening without treatment. The sentence used to qualify "without treatment" but it was a bit clumsy sounding so I think someone took it out. Lesion (talk) 15:02, 30 January 2013 (UTC)

Epidemiology[edit]

History[edit]

Society and culture[edit]

Research[edit]

References[edit]

External links[edit]

  • Doc to review the ones left
Remaining link is to International Continence Society, international in scope and notable with its own page. I think this is fine... Lesion (talk) 14:35, 31 January 2013 (UTC)

Media[edit]

  • Green tickY Copyright status OK

Sourcing[edit]

Post-GA suggestions[edit]

Are we near an end here?[edit]

  • Are we near an end here? The page is 90kb and it's been open nearly three months. Any GA criteria surely would've been met by now given all the detail the review has. Wizardman 17:01, 7 March 2013 (UTC)
Just a few references left to check I think... Lesion (talk) 18:01, 7 March 2013 (UTC)
It's been slow moving but we're still working on it, if it's not causing any trouble would you mind us leaving it open to work on it? This is an article which is hard to find editors to work on or do GA reviews for... Zad68 22:33, 7 March 2013 (UTC)
Yes would like to thank Zad68 for all his excellent comments. There is no time limit really. And taking an article from stub to GA is a major undertaking. Doc James (talk · contribs · email) (if I write on your page reply on mine) 03:11, 8 March 2013 (UTC)
I'm fine leaving it open a bit longer. Just not used to reviews going into so much detail. Not that I'm complaining, clearly that's going to make the article that much better. Wizardman 05:17, 10 March 2013 (UTC)
Yes we have high standards at WP:MED :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:08, 10 March 2013 (UTC)
I was thinking about this myself, simply because this page is a little bit long (which just shows progress)! What if we all decided to close this review, but immediately open another to have a fresh start and a clean GA review to get messy again? =) It may sound silly, but I know I am more willing to leave comments somewhere clean rather than onto a review that is long like this one. Lesion, do you mind withdrawing and starting another GA review, or does that sound de-motivating? For me, it sounds motivating but opinions could easily differ. I'd also like to prevent more random people from popping up and griping about the duration of the review, depsite the article improvement, which should always be the main goal. (That happened to Sasata and I over at Talk:Malaria/GA2.) Or maybe this is a bad suggestion of mine because maybe we really are that close and detailed review is no longer necessary. Biosthmors (talk) 20:13, 10 March 2013 (UTC)
I would be ok with either scenario...would prefer to finish this as I started it...the user who started this thread is also not out of order by commenting - I think it says somewhere GA reviews should only last 1 week? As to whether this RV is near completion, there is a suggestion that zad is going to work through every source. Issues are being raised by this thorough process, so it could be argued that this is worth while, and also probably reflects the guidelines for how to review, see WP:GACN#(1) Well written: "Mistakes to avoid Not checking at least a substantial proportion of sources to make sure that they actually support the statements they're purported to support. (Sources should not be "accepted in good faith": for example, nominators may themselves have left prior material unchecked by assuming good faith."
The only other RV I saw being done was (Talk:Hemorrhoid/GA1), which I was barely involved in, but did seem to be less thorough. Perhaps because it was written from the start by an experienced editor, and here the article started off mostly based on primary sources... Lesion (talk) 22:07, 10 March 2013 (UTC)
I am committed to moving this GAR forward, and I apologize for having gotten side-tracked. There will be progress this week. Zad68 03:17, 11 March 2013 (UTC)

Archived previous review items[edit]

removed primary source[edit]

I am removing this source because it is primary and not significantly contributing to the article. Please feel free to re-add this info if it can be supported with a secondary source.lesion (talk) 15:54, 17 January 2013 (UTC)

  • The randomized trial by Dehli et al. compared injectable bulking agents with sphincter training with biofeedback, and found the former to be superior. The researchers concluded that both methods lead to improvement, but comparisons of St Mark's scores between the groups showed no difference between treatments.<ref name="Dehli 2013">{{cite journal|last=Dehli|first=T|coauthors=Stordahl, A; Vatten, LJ; Romundstad, PR; Mevik, K; Sahlin, Y; Lindsetmo, RO; Vonen, B|title=Sphincter training or anal injections of dextranomer for treatment of anal incontinence: a randomized trial.|journal=Scandinavian journal of gastroenterology|date=2013 Jan 8|pmid=23298304}}</ref>

Types[edit]

Surely "FL generally concerns disorders of IAS function ..." should read, "FI generally concerns disorders of IAS function ...", shouldn't it? Dawright12 (talk) 17:50, 18 March 2013 (UTC)

FL = "fecal leakage". This is a term some researchers have started using to describe incontinence of liquid stool. Since we only use the term once or twice in the article, I will remove the FL abbreviation since it is confusing. Thanks for pointing this out. Lesion (talk) 14:38, 27 March 2013 (UTC)

Colours in the diagram[edit]

It looks that the bones are green ... Why are the colours in the diagram this way? — Preceding unsigned comment added by 92.41.83.249 (talk) 19:22, 19 May 2014 (UTC)

  1. ^ "Weighing a Pill For Weight Loss". Washington Post. Retrieved 2007-07-06. "While the Food and Drug Administration (FDA) still must approve the switch, the agency often follows the advice of its experts. If it does, Orlistat (xenical) -- currently sold only by prescription -- could be available over-the-counter (OTC) later this year. But it's important to know that the weight loss that's typical for users of the drug -- 5 to 10 percent of total weight -- will be less than many dieters expect. And many consumers may be put off by the drug's significant gastrointestinal side effects, including flatulence, diarrhea and anal leakage." 
  2. ^ "Frito-Lay Study: Olestra Causes "Anal Oil Leakage"". Center for Science in the Public Interest. Thursday, February 13, 1997. Retrieved 2007-07-07. "The Frito-Lay report states: "The anal oil leakage symptoms were observed in this study (3 to 9% incidence range above background), as well as other changes in elimination. ... Underwear spotting was statistically significant in one of two low level consumer groups at a 5% incidence above background." Despite those problems, the authors of the report concluded that olestra-containing snacks "should have a high potential for acceptance in the marketplace.""  Check date values in: |date= (help)
  3. ^ "The Word Is 'Leakage'. Accidents may happen with a new OTC diet drug.". Newsweek. June 25, 2007. Retrieved 2007-06-21. "GlaxoSmithKline has a tip for people who decide to try Alli, the over-the-counter weight-loss drug it is launching with a multimillion-dollar advertising blitz—keep an extra pair of pants handy. That's because Alli, a lower-dose version of the prescription drug Xenical, could (cue the late-night talk-show hosts) make you soil your pants. But while Alli's most troublesome side effect, anal leakage, is sure to be good for a few laughs, millions of people who are desperate to take off weight may still decide the threat of an accident is worth it."  Check date values in: |date= (help)
  4. ^ Cite error: The named reference CSPI2 was invoked but never defined (see the help page).
  5. ^ a b c d e f g h Hosker, G; Cody, JD; Norton, CC (2007 Jul 18). "Electrical stimulation for faecal incontinence in adults.". Cochrane database of systematic reviews (Online) (3): CD001310. doi:10.1002/14651858.CD001310.pub2. PMID 17636665.  Check date values in: |date= (help)
  6. ^ a b Norton, C; Cody, JD (2012 Jul 11). "Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults.". Cochrane database of systematic reviews (Online) 7: CD002111. doi:10.1002/14651858.CD002111.pub3. PMID 22786479.  Check date values in: |date= (help)
  7. ^ Cite error: The named reference ASCRS_core_subjects_FI was invoked but never defined (see the help page).