U.S. Department of Health and Human Services
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Developing a Clinical Research Agenda for Fecal Incontinence

8/19/2013 9:00 AM
8/20/2013 5:00 PM
Yes
No
 

Event Details

Program Overview
 
Fecal incontinence is a condition with ramifications that extend well beyond their physical manifestations. Many individuals find themselves withdrawing from their social lives and attempting to hide the problem from their families, friends, and even their doctors. The shame, embarrassment, and stigma associated with these conditions pose significant barriers to seeking professional treatment, resulting in many persons who suffer from these conditions without help. As baby boomers approach their 60s, the incidence and public health burden of incontinence are likely to increase.
 
Fecal incontinence is a syndrome that involves the unintentional loss of solid or liquid stool. It is serious and embarrassing. Fecal incontinence may affect individuals living at home, as well as many living in nursing homes. Although fecal incontinence affects individuals of all ages, it is more common in women and older persons. Bowel function is controlled by four factors: rectal sensation, rectal storage capacity, anal sphincter pressure, and established bowel habits. If any of these is compromised, fecal incontinence can occur. Despite its serious effects on patients, families, and society, fecal incontinence is often ignored and has been studied less than many other conditions.
 
It has been difficult to identify persons at risk for or affected by fecal incontinence because the condition is often not reported or diagnosed. Prevention of fecal incontinence has been hindered by limited research and incomplete knowledge about the biological causes and interacting social and environmental factors.
 
The workshop will include a panel of experts in epidemiology, gastrointestinal physiology, gastroenterology, colorectal surgery, urogynecology, psychology, and behavioral medicine. During the workshop, they will identify and discuss major issues in the diagnoses and treatment of fecal incontinence. In addition, the panel will examine the barriers encountered in addressing fecal incontinence. Furthermore, the panel will be charged to develop research priorities in both basic and clinical research to further advance treatment strategies for fecal incontinence.
 
Target Audience
 
The intended audience for this workshop is gastroenterologist s, colorectal surgeons, urogynecologists behavioralists, psychologists, and basic scientists with an interest in anorectal disorders and other health care professionals with a potential involvement in the identification, assessment, and treatment of patients with fecal incontinence.

Agenda

​DAY ONE: Monday, August 19, 2013

Session One: Epidemiology of Fecal Incontinence (FI)
Moderator: Frank Hamilton, M.D., M.P.H., National Institute of Diabetes and Digestive and Kidney Diseases
Co-Moderator: Madhulka Varma, M.D., University of California, San Francisco​
​​ 8:30 a.m. ​Introductory Remarks
Janine Clayton, M.D., Director of the Office of Research on Women's Health
​8:50 a.m. ​How to advance research opportunities in Fecal Incontinence: A charge to the Research and Clinical Communities
Stephen James, M.D., Director, Division of Digestive Diseases and Nutrition
​9:00​ a.m. ​Moderator Welcoming Remarks and Introductions
​9:05 a.m. ​Epidemiology and Prevalence of Fecal Incontinence
Alayne Markland, D.O., M.Sc., University of Alabama at Birmingham, Department of Medicine
​9:35 a.m. ​Burden and Economic Impact of Fecal Incontinence
Catherine Matthews, M.D., University of North Carolina at Chapel Hill
​10:05 a.m. ​Measuring the Burden of Fecal Incontinence and Developing Treatment Endpoints
Rebecca Rogers, M.D., University of New Mexico Hospital
​10:35 a.m. ​Break
​11:00 a.m. ​Patient Personal Perspective
Louise Mott, R.N., Simon Foundation
​11:30 a.m. ​Barriers to Consulting and Screening
Gena Dunivan, M.D., University of New Mexico
​12:00 p.m. ​Panel Discussion
​12:30 p.m. ​Lunch
​Session Two: Etiology, Quantification, and Classification of Fecal Incontinence
Moderator: Dana Andersen, M.D., National Institute of Diabetes and Digestive and Kidney Diseases
Co-Moderator: Patricia Goode, M.D., R.N., University of Alabama at Birmingham
​1:30 p.m. ​Moderator Welcoming Remarks and Introductions
​1:35 p.m. ​Etiology, Mechanism, and Classification of Fecal Incontinence
Adil Bharucha, M.D., Division of Gasteroenterology and Hepatology, Mayo Clinic
​2:05 p.m. ​Fecal Incontinence in the Elderly Including in Nursing Homes
Patricia Goode, M.D., M.S.N., University of Alabama at Birmingham
​2:35 p.m. Break
​3:00 p.m. ​Obstetric Injury as a Cause of Fecal Incontinence
Emily Lukacz, M.D., University of California, San Diego
​3:30 p.m. ​Measurement/Quantification of Fecal Incontinence
Alan R. Zinsmeister, Ph.D., Division of Biomedical Statistics and Informatics, Mayo Clinic
​4:00 p.m. ​Panel Discussion

 DAY TWO: Tuesday, August 20, 2013

 

Session Three: Review of Past Fecal Incontinence Treatment Studies: Successes and Deficiencies in Research
Moderator: Satish Rao, M.D., Ph.D., Internal Medicine, Gastroenterology, and Pediatric Gastroenterology, Georgia Regents University
Co-moderator: William Whitehead, Ph.D., Center for Functional GI and Motility Disorders, University of North Carolina ​
​8:00 a.m. ​Recap From Day One
Drs. Rao and Whitehead
​8:15 a.m. ​Moderator Welcoming Remarks and Introductions
​8:20 a.m. ​Medical/Pharmacological Trials in Fecal Incontinence
Satish Rao, M.D., Ph.D., Internal Medicine, Gastroenterology, and Pediatric Gastroenterology, Georgia Regents University
​8:50 a.m. ​Surgical Treatment Studies
Ann Lowry, M.D., University of Minnesota Medical Center
​9:20 a.m. ​Medical Devices for Treatment of Fecal Incontinence (to Include Sacral Nerve Stimulation and Solesta)
Debora Nagle, M.D., Harvard Medical Faculty Physicians (HMFP) at Beth Israel Deaconess Medical Center
​9:50 a.m. ​Panel Discussion
​10:20 a.m. ​BREAK
​Session Four: Strategies for Future Treatment Studies of Fecal Incontinence
Moderator: Susan Meikle, M.D., Gynecologic Health and Disease Branch (GHDB), National Institutes of Health
Co-Moderator: Catherine Matthews
​10:40​ a.m. ​Moderator Welcoming Remarks and Introductions
​10:45 a.m. ​Medical and Behavioral Treatment of Fecal Incontinence
William Whitehead, Ph.D., Center for Functional GI and Motility Disorders, University of North Carolina
​11:15 a.m. ​Surgical Intervention for Treatment of Fecal Incontinence
Madhulka Varma, M.D., University of California, San Francisco
​11:45 a.m. ​Basic Mechanisms Responsible for Fecal Continence and Implications for Future Clinical Trials
Khalil Bitar, Ph.D., Institute for Regenerative Medicine at Wake Forest Baptist Medical Center
​12:15 p.m. ​Panel Discussion
​Session Five: Wrap Up: Where We Go From Here
12:45 p.m. ​Drs. Bharucha and Whitehead
​1:00 p.m. ​ADJOURNMENT
 

 

Directions/Travel

​Hyatt Regency Bethesda
One Bethesda Metro Center
Bethesda, MD  20814
Phone:  301-657-1234
Fax:  301-657-6453

Web Site:  http://www.bethesda.hyatt.com  

 
Meeting Location
Lister Hill Auditorium
Building 38A, NIH Campus
Bethesda, MD
 
A block of sleeping rooms has been reserved at the Hyatt Regency Bethesda in Bethesda, MD, for out-of-town guests attending the NIDDK Developing a Clinical Research Agenda for Fecal Incontinence Meeting on August 19-20, 2013.
A block of sleeping rooms has been reserved at the hotel for arrival on Sunday, August 18, 2013, and departure on Tuesday, August 20, 2013. You may make reservations by calling the hotel directly at (301)657-1234. Be sure to indicate that you are requesting a room for NIDDK room block when making your reservations to receive this reduced rate. The room block will be in effect at the reduced rate until Friday, August 3, 2013. Any room reservations received after that date will be accepted on a space and rate availability basis. Please note that reservations must be cancelled no later than 24 hours prior to the scheduled arrival date or one night’s room and tax will be charged. Check-in time is 3:00 p.m., and check-out time is 12:00 p.m. 
 
DIRECTIONS
From Points North:
From I-95: Take I-95 South to I-495 (Capital Beltway) West toward Silver Spring. Take Exit 34 (Wisconsin Avenue/Route 355). Follow Route 355 South for approximately 3 miles and the Hyatt Regency Bethesda will be on the right, on the corner of Wisconsin Avenue and Old Georgetown Road.
 
From I-270:
Take I-270 South to I-495 (Capital Beltway) East toward Washington, DC. Stay in one of the three left lanes. Follow signs for 355 South, a left-lane exit, onto Wisconsin Avenue. Follow Route 355 South for approximately 3 miles and the Hyatt Regency Bethesda will be on the right, on the corner of Wisconsin Avenue and Old Georgetown Road.
 
From Points South:
Take I-95 North to I-495 (Capital Beltway) toward Tysons Corner/Rockville. Follow I-495 for 20 miles. At the I-495/I-270 split, stay to the right on I-495. Take Exit 34 (Wisconsin Avenue/Route 355). Follow Route 355 South for approximately 3 miles and the Hyatt Regency Bethesda will be on the right, on the corner of Wisconsin Avenue and Old Georgetown Road.
 
From Baltimore/Washington International Thurgood Marshall Airport (BWI):
Take Route 195 West to Exit 4 (I-95 South). From I-95 take I-495 (Capital Beltway) West toward Silver Spring. Take Exit 34 (Wisconsin Avenue/Route 355). Follow Route 355 South for approximately 3 miles and the Hyatt Regency Bethesda will be on the right, on the corner of Wisconsin Avenue and Old Georgetown Road.
 
From Washington Dulles International Airport (IAD):
Take the Dulles Access Road for approximately 13 miles to Exit 18. Move to the right on the Dulles Toll Road (Route 267); get off at Exit 18. Stay to the left on the ramp for Bethesda/Baltimore and proceed toward Bethesda on I-495 (Capital Beltway) for approximately 9 miles. At the I-495/I-270 split, stay to the right on I-495. Take Exit 34 (Wisconsin Avenue/Route 355 South). Follow Route 355 South for approximately 3 miles and the Hyatt Regency Bethesda will be on the right, on the corner of Wisconsin Avenue and Old Georgetown Road.
 
From Ronald Reagan National Airport (DCA):
Take the George Washington Parkway North to I-495 (Capital Beltway) and follow the signs to Maryland. At the I-495/ I-270 split, stay to the right on I-495. Take Exit 34 (Wisconsin Avenue/Route 355). Follow Route 355 South for approximately 3 miles and the Hyatt Regency Bethesda will be on the right, on the corner of Wisconsin Avenue and Old Georgetown Road.
 
METRO INFORMATION
The Metro  System is clean, reliable, and safe. It operates from 5:30 a.m. to 12:00 midnight Monday through Thursday; 5:00 a.m. to 2:00 a.m. on Fridays; 8:00 a.m. to 2:00 a.m. on Saturdays; and 8:00 a.m. to 12:00 midnight on Sundays. Each passenger must buy a farecard to travel in the system. Guides for purchasing farecards are posted on the vending machines in each station. Each Metro car features a complete color-coded map. Station attendants on duty at each station can provide additional information on request.
 
From Union Station or downtown Washington (main Metro Lines into the city converge at Metro Center Station and Gallery Place Station), take the Metro Red Line toward Shady Grove or Grosvenor. Exit at the Bethesda Metro Station. The Hyatt is directly above the Bethesda Metro Station.  For additional information, please visit:  http://www.wmata.com  .
 
SHUTTLES
SuperShuttle offers service to most hotels from Ronald Reagan National Airport, Washington Dulles International Airport, and Baltimore/Washington International Thurgood Marshall Airport. The shuttle leaves on an as-needed basis between the hours of 5:30 a.m. and 11:00 p.m. During other times, arrange for a shuttle by calling 800-258-3826 from the airport.  For further information on SuperShuttle, visit http://www.supershuttle.com  .
 
TAXIS
The taxi fare is approximately $30 from Ronald Reagan National Airport, approximately $40 from Washington Dulles International Airport, and approximately $55 from Baltimore/Washington International Thurgood Marshall Airport.
 
MARC Trains
From BWI Airport, take the MARC train on the Penn Line to Union Station. Take the Metro Red Line toward Grosvenor or Shady Grove and exit at the Bethesda Metro Station. The hotel is directly above the Bethesda Metro Station.
 
Parking Information Self-parking at the hotel is $12 per day/overnight ($9 on Friday and Saturday). Valet parking is $14 per day/overnight ($11 on Friday and Saturday).
 

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