[Federal Register: July 24, 2007 (Volume 72, Number 141)]
[
Notices]
[Page 40316-40317]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr24jy07-86]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
State-of-the-Science Conference: Prevention of Fecal and Urinary
Incontinence in Adults; Notice
Notice is hereby given of the National Institutes of Health (NIH)
``State-of-the-Science Conference: Prevention of Fecal and Urinary
Incontinence in Adults'' to be held December 10-12, 2007, in the NIH
Natcher Conference Center, 45 Center Drive, Bethesda, Maryland 20892.
The conference will begin at 8:30 a.m. on December 10 and 11, and at 9
a.m. on December 12, and will be open to the public.
Fecal and urinary incontinence--the inability to control bowel
movements or urination, respectively--are conditions with ramifications
that extend well beyond their physical manifestations. Many people find
themselves withdrawing from their social lives and attempting to hide
the problem from their families, friends, and even their doctors. The
embarrassing nature of these conditions poses a significant barrier to
seeking professional treatment, resulting in a large number of
unreported, untreated individuals. Therefore, it is difficult to
determine the accurate prevalence of these conditions, as well as any
associated medical history trends. Incontinence is more likely to
affect the aging population, although it is not considered a normal
consequence of aging. As baby boomers approach their 60s, the incidence
and public health burden of incontinence are likely to increase.
Fecal incontinence is a serious and embarrassing problem that
affects up to 5 percent of the general population and up to 39 percent
of nursing home residents. It affects people of all ages but is more
common in women and the elderly. Bowel function is controlled by three
factors: rectal sensation, rectal storage capacity, and anal sphincter
pressure. If any of these are compromised, fecal incontinence can
occur. This condition can have many causes, including constipation,
diarrhea, complicated childbirth, muscular or nerve damage, reduced
storage capacity due to scarring or irritation, or pelvic dysfunction.
Although urinary incontinence can affect people at all stages of
life, it has been estimated that urinary incontinence affects 38
percent of women and 17 percent of men 60 years of age and older.
Urinary incontinence can occur if muscles in the wall of the bladder
suddenly contract or if muscles surrounding the urethra suddenly relax.
Women who have undergone childbirth are the most commonly associated
at-risk population for urinary incontinence. Pregnancy and delivery can
weaken pelvic muscles, and reduced levels of the hormone estrogen
following menopause can cause reduced muscle tone around the urethra,
increasing the chance of leakage. Additionally, neurologic injury,
birth defects, strokes, multiple sclerosis, and physical problems
associated with aging have been reported to contribute.
Because incontinence is likely widely underdiagnosed and
underreported, it has been difficult to identify both at-risk and
affected populations. Also, because the biological mechanisms that
cause both fecal and urinary incontinence are not well understood, it
has been difficult to develop robust prevention and management
strategies. Toward that end, the National Institute of Diabetes and
Digestive and Kidney Diseases and the Office of Medical Applications of
Research of the NIH will convene a State-of-the-Science Conference from
December 10 to 12, 2007, to assess the available scientific evidence
relevant to the following questions:
What are the prevalence, incidence, and natural history of
fecal and urinary incontinence in the community and long-term care
settings?
What is the burden of illness and impact of fecal and
urinary incontinence on the individual and society?
What are the risk factors for fecal and urinary
incontinence?
What can be done to prevent fecal and urinary
incontinence?
What are the strategies to improve the identification of
persons at risk and patients who have fecal and urinary incontinence?
What are the research priorities in reducing the burden of
illness in these conditions?
An impartial, independent panel will be charged with reviewing the
available published literature in advance of the conference, including
a systematic literature review commissioned through the Agency for
Healthcare Research and Quality. The first day and a half of the
conference will consist of presentations by expert researchers and
practitioners and open public discussions. On Wednesday, December 12,
the panel will present a statement of its collective assessment of the
evidence to answer each of the questions above. The panel will also
hold a press conference to address questions from the media. The draft
statement will be published online later that day, and the final
version will be released approximately six weeks later. The primary
sponsors of this meeting are the National Institute of Diabetes and
Digestive and Kidney Diseases and the NIH Office of Medical
Applications of Research.
Advance information about the conference and conference
registration materials may be obtained from American Institutes for
Research of Silver Spring, Maryland, by calling 888-644-2667, or by
sending e-mail to consensus@mail.nih.gov. American Institutes for
Research's mailing address is 10720 Columbia Pike, Silver Spring, MD
20901. Registration information is also available on the NIH Consensus
Development Program Web site at http://consensus.nih.gov.
Please Note: The NIH has instituted security measures to ensure
the safety of NIH employees and property. All visitors must be
prepared to show a photo ID upon request. Visitors may be required
to pass through a metal detector and have bags, backpacks, or
[[Page 40317]]
purses inspected or x-rayed as they enter NIH buildings. For more
information about the new security measures at NIH, please visit the
Web site at http://www.nih.gov/about/visitorsecurity.htm.
Dated: July 12, 2007.
Raynard S. Kington,
Deputy Director, National Institutes of Health.
[FR Doc. E7-14208 Filed 7-23-07; 8:45 am]
BILLING CODE 4140-01-P