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5.
J Aquat Anim Health ; 33(1): 17-23, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33713491

RESUMEN

Reports of intussusception in sea turtles are generally linked to marine debris ingestion; therefore, only a few cases of the disease are associated with parasitic infestations. The objective of this study was to describe the necropsy findings of the first reported case of colocolic intussusception in a green sea turtle Chelonia mydas, associated with the helminth Octangium sp. A juvenile female green sea turtle, which was registered and rescued by the team from the Cetaceans Project of Costa Branca, State University of Rio Grande do Norte, was examined. The animal died 1 d after being treated and was immediately submitted for necropsy. Our findings indicated that parasitic infestation by Octangium sp. in the green sea turtle caused intussusception and consequently led to the animal's death. Early diagnosis and surgical correction are fundamental for a good prognosis and, consequently, for successful rehabilitation of marine species.


Asunto(s)
Enfermedades del Colon/veterinaria , Intususcepción/veterinaria , Trematodos/aislamiento & purificación , Infecciones por Trematodos/veterinaria , Tortugas , Animales , Brasil , Enfermedades del Colon/diagnóstico , Enfermedades del Colon/diagnóstico por imagen , Enfermedades del Colon/parasitología , Enfermedades Funcionales del Colon , Femenino , Enfermedades del Sigmoide , Infecciones por Trematodos/diagnóstico , Infecciones por Trematodos/diagnóstico por imagen , Infecciones por Trematodos/parasitología
6.
Ribeirão Preto; s.n; 2021. 175 p. ilus.
Tesis en Portugués | LILACS, BDENF | ID: biblio-1378353

RESUMEN

Trata-se de um estudo de desenho misto, do tipo sequencial explanatório, sendo que na etapa quantitativa descritiva e transversal, objetivou-se analisar a demanda de atendimento de assistência de pessoas com queixas colorretais em Unidades de Saúde da Família no Sistema Único de Saúde (SUS); e na etapa qualitativa exploratória, interpretar o mapa de cuidado de pessoas com adoecimento colorretal crônico no SUS (Parecer No. 210/2018 CEP/EERP-USP). Na etapa quantitativa aplicou-se um instrumento de coleta de dados, elaborado pelas pesquisadoras, com base na revisão de literatura, para caracterização sociodemográfica, clínica, terapêutica e de referência de participantes usuários da Estratégia Saúde da Família com queixas colorretais, mediante critérios de inclusão e exclusão, no período de abril a setembro de 2019. A análise estatística descritiva dos dados indicou, que do total de 107 participantes, predominou 78 (72,9%) que tinham idade acima de 60 anos, 64 (59,8%) eram do sexo feminino, 61 (57%) tinham até oito anos de estudos, 68 (63,65) com companheiro, 56 (52,3%) eram aposentados, 45 (42,1%) apresentavam renda de até um salário mínimo e 95 (88,8%) não possuíam plano de saúde privado, sendo que o encaminhamento para o nível secundário foi devido ao protocolo de rastreamento para 62 (57,9%) e 45 (42,1%) por queixa colorretal, todos haviam realizado a Pesquisa de Sangue Oculto e destes, 78% tiveram resultado positivo; todos os entrevistados haviam recebido encaminhamento para realizar a colonoscopia. Além disso, 78 (72,9%) eram sedentários; e 66 (61,7%) consumiam carne vermelha e 45 (42,1%) embutidos. A análise univariada da associação das variáveis hábitos de vida, resultado de colonoscopia, presença de alterações displásicas ou doença colorretal não foi estatisticamente significante entre consumo de carne vermelha, consumo de embutidos ou ambos com o desfecho de colonoscopia normal, displasia intestinal com potencial neoplásico e doença diverticular ou orificial. Estes resultados dimensionaram o contexto de atendimento desta clientela na Atenção Primária à Saúde (APS), auxiliando o refinamento dos critérios de seleção dos possíveis participantes da etapa qualitativa. A etapa qualitativa foi realizada, no período de junho de 2020 a julho de 2020, mediante os critérios de seleção: pessoas acima de 18 anos, de ambos os sexos, com diagnóstico colorretal crônico: Doença inflamatória intestinal ou Neoplasia colorretal em internação especialidade de Coloproctologia de um hospital universitário público, de assistência terciária/quaternária. Nesta etapa, os dados foram coletados por meio de entrevistas individuais em profundidade com 14 participantes, cuja caracterização sociodemográfica, clínica e terapêutica revelou internação para tratamento cirúrgico, com maior gravidade clínica, sendo que 13 apresentavam diagnóstico de Neoplasia colorretal. Utilizou-se questões norteadoras, diário de campo, observação não participante e participante para a obtenção dos dados, que foram interpretados com Análise Temática, fundamentado pela Epidemiologia Social. O Mapa de Cuidado construído por estes, iniciou-se com queixas e sinais/sintomas gastrointestinais, envolvendo situações de maior gravidade clínica, com sofrimento físico e psicoemocional; diagnosticados como parasitose, hemorroidas e anemia na APS, cujos tratamentos não foram resolutivos. Para esta interpretação, articulou-se as ações destes participantes às suas queixas, à condição socioeconômica, cultural e psicoemocional, assim como à capacidade de enfrentamento do adoecimento oncológico e dos tratamentos, no qual ocorreu a focalização da vida destes e de suas famílias nos acontecimentos clínicos e terapêuticos do contexto de atendimento terciário/quaternário. O acesso aos serviços do SUS ocorreu de diferentes maneiras, com utilização de estratégias que agilizaram e asseguraram a resolução do seu problema de saúde, sendo que o agir leigo foi uma produção social, no cotidiano do SUS, mediado pelos acontecimentos, pelas ações dos profissionais e de suas próprias ações ou pelo sistema de apoio social, enfatizando-se o sofrimento desta clientela na busca pela assistência à saúde. Este mapa de cuidado mostrou que o agir leigo constituiu uma regulação assistencial no SUS, tão importante quanto as outras formas, composto pelos vínculos dos pacientes com profissionais dos serviços dos níveis primário, secundário, terciário/quaternário, de suas necessidades e possibilidades, além dos pontos de acesso ao sistema. Estes resultados poderão contribuir na implementação da gestão de cuidados de pessoas com adoecimento colorretal crônico no SUS, dando voz e protagonismo àquele que busca pela assistência à saúde


This is a study of mixed design, of an explanatory sequential type, and in the quantitative descriptive and transversal stage, the objective was to analyze the demand for assistance from people with colorectal symptoms in Family Health Units in the Unified System Health (SUS); and in the qualitative exploratory stage, interpret the care map for people with chronic colorectal illness in SUS (Note Nº. 210/2018 CEP / EERP-USP). In the quantitative stage, a data collection instrument was developed by the researchers, based on the literature review, for sociodemographic, clinical, therapeutic, and reference characterization of participating users of the Family Health Strategy with colorectal symptoms, considering inclusion and exclusion criteria, from April to September 2019. The descriptive statistical analysis of the data indicated that, out of a total of 107 participants, 78 (72.9%) predominated who were over 60 years old, 64 (59.8%) were female, 61 (57%) had up to eight years of study, 68 (63.65) with a partner, 56 (52.3%) were retired, 45 (42.1%) had an income of up to one minimum wage and 95 (88.8%) did not have a private health plan, and the referral to the secondary level was due to the screening protocol for 62 (57.9%) and 45 (42.1%) due to colorectal complaints, all had carried out the Occult Blood Survey and of these, 78% had a positive result; all respondents had been referred for colonoscopy. In addition, 78 (72.9%) were sedentary; and 66 (61.7%) consumed red meat and 45 (42.1%) sausages. The univariate analysis of the association of the variables life habits, the result of colonoscopy, presence of dysplastic changes or colorectal disease was not statistically significant between consumption of red meat, consumption of sausages or both with the outcome of normal colonoscopy, intestinal dysplasia with neoplastic potential and diverticular or artificial disease. These results have dimensioned the context of care for this clientele in Primary Health Care (PHC), helping to refine the selection criteria of possible participants in the qualitative stage. The qualitative stage was carried out, from June 2020 to July 2020, using the selection criteria: people over 18 years of age, of both sexes, with chronic colorectal diagnosis: Inflammatory bowel disease or Colorectal neoplasia in Coloproctology specialty hospitalization of a public university hospital, of tertiary/quaternary assistance. In this stage, data were collected through in-depth individual interviews with 14 participants, whose sociodemographic, clinical, and therapeutic characterization revealed hospitalization for surgical treatment, with greater clinical severity, with 13 presenting a diagnosis of colorectal neoplasia. Guiding questions, field diary, non-participant and participant observation were used to obtain the data, which were interpreted with Thematic Analysis, based on Social Epidemiology. The Care Map built by them started with gastrointestinal complaints and signs/symptoms, involving situations of greater clinical severity, with physical and psycho-emotional suffering; diagnosed as parasitosis, hemorrhoids, and anemia in PHC, whose treatments were not effective. For this interpretation, the actions of these participants were linked to their complaints, to their socioeconomic, cultural, and psycho-emotional condition, as well as to their ability to cope with oncological illness and treatments, in which the lives of these and their families were focused on the events and therapeutic aspects of the tertiary/quaternary care context. Access to SUS services occurred in different ways, using strategies that streamlined and ensured the resolution of their health problem, and the lay agency as social production, in the daily routine of SUS, mediated by events, by the actions of professionals and their actions or the social support system, emphasizing the suffering of this clientele in the search for health care. This care map showed that the lay act constituted an assistance regulation in SUS, as important as the other forms, composed by the bonds of patients with professionals from the services of the primary, secondary, tertiary/quaternary levels, of their needs and possibilities, in addition to the access points to the system. These results may contribute to the implementation of the care management of people with chronic colorectal illness in SUS, giving voice and leadership to those seeking health care.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Atención Primaria de Salud , Derivación y Consulta , Sistema Único de Salud , Enfermedades Inflamatorias del Intestino/tratamiento farmacológico , Enfermedades Funcionales del Colon/tratamiento farmacológico , Accesibilidad a los Servicios de Salud
7.
J Surg Res ; 254: 247-254, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32480068

RESUMEN

BACKGROUND: A successful flush is the ability to flush through the appendicostomy or cecostomy channel, empty the flush through the colon, and achieve fecal cleanliness. We evaluated our experience with patients who were having flush difficulties based on a designed algorithm. METHODS: Eight patients with flush difficulties were initially evaluated. Based on the need for additional surgery versus changes in bowel management therapy (BMT), we developed an algorithm to guide future management. The algorithm divided flush issues into before, during, and after flushing. Children aged <20 y who presented with flush issues from September 2018 to August 2019 were evaluated to determine our algorithm's efficacy. Specific outcomes analyzed included changes in BMT versus need for additional surgery. RESULTS: After algorithm creation, 29 patients were evaluated for flush issues. The median age was 8.4 y (interquartile range: 6, 14); 66% (n = 19) were men. Underlying diagnoses included anorectal malformations (n = 17), functional constipation (n = 7), Hirschsprung's disease (n = 2), spina bifida (n = 2), and prune belly (n = 1). A total of 35 flush issues/complaints were noted: 29% before the flush, 9% during the flush, and 63% after the flush. Eighty percent of issues before the flush required surgical intervention, wherease 92% of issues during or after the flush were managed with changes in BMT. CONCLUSIONS: Most flush issues respond to changes in BMT. This algorithm can help delineate which types of flush issues would benefit from surgical intervention and what problems might be present if patients are not responding to changes in their flush regimen.


Asunto(s)
Malformaciones Anorrectales/rehabilitación , Cecostomía/rehabilitación , Enfermedades Funcionales del Colon/rehabilitación , Enema , Adolescente , Algoritmos , Niño , Femenino , Humanos , Masculino , Estudios Retrospectivos
8.
Neurogastroenterol Motil ; 32(2): e13762, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31756783

RESUMEN

INTRODUCTION: Chronic constipation is a common disorder with a reported prevalence ranging from 3% to 27% in the general population. Several management strategies, including diagnostic tests, empiric treatments, and specific treatments, have been developed. Our aim was to develop European guidelines for the clinical management of constipation. DESIGN: After a thorough review of the literature by experts in relevant fields, including gastroenterologists, surgeons, general practitioners, radiologists, and experts in gastrointestinal motility testing from various European countries, a Delphi consensus process was used to produce statements and practical algorithms for the management of chronic constipation. KEY RESULTS: Seventy-three final statements were agreed upon after the Delphi process. The level of evidence for most statements was low or very low. A high level of evidence was agreed only for anorectal manometry as a comprehensive evaluation of anorectal function and for treatment with osmotic laxatives, especially polyethylene glycol, the prokinetic drug prucalopride, secretagogues, such as linaclotide and lubiprostone and PAMORAs for the treatment of opioid-induced constipation. However, the level of agreement between the authors was good for most statements (80% or more of the authors). The greatest disagreement was related to the surgical management of constipation. CONCLUSIONS AND INFERENCES: European guidelines on chronic constipation, with recommendations and algorithms, were developed by experts. Despite the high level of agreement between the different experts, the level of scientific evidence for most recommendations was low, highlighting the need for future research to increase the evidence and improve treatment outcomes in these patients.


Asunto(s)
Enfermedades Funcionales del Colon/terapia , Estreñimiento/terapia , Adulto , Femenino , Humanos , Masculino
9.
Am J Gastroenterol ; 114(11): 1772-1777, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31592781

RESUMEN

OBJECTIVES: The impact of opioids on anorectal function is poorly understood but potentially relevant to the pathogenesis of opioid-induced constipation (OIC). To evaluate anorectal function testing (AFT) characteristics, symptom burden, and quality of life in chronically constipated patients prescribed an opioid (OIC) in comparison with constipated patients who are not on an opioid (NOIC). METHODS: Retrospective analysis of prospectively collected data on 3,452 (OIC = 588 and NOIC = 2,864) chronically constipated patients (Rome 3) who completed AFT. AFT variables included anal sphincter pressure and response during simulated defecation, balloon expulsion test (BET), and rectal sensation. Dyssynergic defecation (DD) was defined as an inability to relax the anal sphincter during simulated defecation and an abnormal BET. Patients completed Patient Assessment of Constipation Symptoms (PAC-SYM) and Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaires. RESULTS: The mean age of the study cohort was 49 years. Most patients were women (82%) and whites (83%). Patients with OIC were older than NOIC patients (50.7 vs 48.3, P = 0.001). OIC patients were significantly more likely to have DD (28.6% vs 21.4%, P < 0.001), an abnormal simulated defecation response on anorectal manometry (59% vs 43.8%, P < 0.001), and an abnormal BET (48% vs 42.5%, P = 0.02) than NOIC patients. OIC patients reported more severe constipation symptoms (P < 0.02) and worse quality of life (P < 0.05) than NOIC patients. DISCUSSION: Chronically constipated patients who use opioids are more likely to have DD and more severe constipation symptoms than NOIC.


Asunto(s)
Analgésicos Opioides/efectos adversos , Ataxia , Enfermedades Funcionales del Colon , Estreñimiento , Calidad de Vida , Enfermedades del Recto , Ataxia/inducido químicamente , Ataxia/diagnóstico , Ataxia/fisiopatología , Enfermedad Crónica , Enfermedades Funcionales del Colon/inducido químicamente , Enfermedades Funcionales del Colon/diagnóstico , Enfermedades Funcionales del Colon/fisiopatología , Estreñimiento/diagnóstico , Estreñimiento/etiología , Estreñimiento/fisiopatología , Estreñimiento/psicología , Costo de Enfermedad , Defecación , Femenino , Humanos , Masculino , Manometría/métodos , Persona de Mediana Edad , Enfermedades del Recto/inducido químicamente , Enfermedades del Recto/diagnóstico , Enfermedades del Recto/fisiopatología , Índice de Severidad de la Enfermedad
10.
Neurodegener Dis Manag ; 9(2): 83-89, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30998082

RESUMEN

Aim: Functional constipation is common in multiple sclerosis (MS) and first line treatments are frequently ineffective. The current study explored the use of abdominal functional electrical stimulation (ABFES) for treating constipation in MS. Patients/methods: 20 people with MS and constipation (ROME IV criteria). The patient assessment of constipation-related quality of life questionnaire was administered at baseline and after 6 weeks of ABFES treatment alongside semi-structured interviews. Results: All patient assessment of constipation-related quality of life subscales were significant: satisfaction (p = 0.003), psychosocial discomfort (p = 0.008), physical discomfort (p = 0.001) and worries and concerns (p = 0.003). A long-term therapeutic effect, reduction in laxative use and improved sexual functioning were also reported. Conclusion: ABFES provides a potential alternative treatment intervention for people with MS and constipation.


Asunto(s)
Músculos Abdominales , Enfermedades Funcionales del Colon/terapia , Estreñimiento/terapia , Terapia por Estimulación Eléctrica , Esclerosis Múltiple/complicaciones , Evaluación de Resultado en la Atención de Salud , Adulto , Enfermedades Funcionales del Colon/etiología , Estreñimiento/etiología , Terapia por Estimulación Eléctrica/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida
12.
Am J Med Genet A ; 179(5): 817-821, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30790422

RESUMEN

Retinoic acid receptor beta (RARB) variants are heavily linked to pathologies of neural crest cell migration. The purpose of this report is to present a 23-month-old male with the previously described R387C RARB gain-of-function variant whose gastrointestinal issues and long-term constipation lead to the discovery of colonic hypoganglionosis. This case further delineates the pattern of malformation associated with RARB variants. The findings are also consistent with the known etiology of aganglionic colon due to failed neural crest cell migration.


Asunto(s)
Enfermedades Funcionales del Colon/diagnóstico , Enfermedades Funcionales del Colon/etiología , Estreñimiento/diagnóstico , Estreñimiento/etiología , Predisposición Genética a la Enfermedad , Variación Genética , Receptores de Ácido Retinoico/genética , Alelos , Exoma , Humanos , Lactante , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Mutación con Pérdida de Función , Masculino , Radiografía , Secuenciación del Exoma
13.
Neurogastroenterol Motil ; 31(1): e13441, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30125427

RESUMEN

BACKGROUND: Patients with functional chronic constipation (CFC) often select nonpharmacological treatments. We aimed to examine the comparative effectiveness of nonpharmacological conservative treatments in treating CFC. METHODS: We searched MEDLINE, EMBASE, Cochrane library, CINAHL, AMED, ISI web of knowledge, and conference proceedings from January 2000 to June 2016. Randomized controlled trials comparing nonpharmacological conservative treatments with placebo, sham interventions, or conventional treatments were included. Nonpharmacological conservative treatments were defined as interventions without involvement of medication or surgery. We extracted trial data in duplicate and assessed the risk of bias. We pooled continuous data using standard mean differences (SMDs) and binary data using risk ratios (RRs), and we provided their 95% confidence intervals. KEY RESULTS: We included 33 trials (4324 participants and 8 nonpharmacological treatments). Compared with placebo interventions, TENS (SMD 1.60, 95% CI 0.28-2.92), probiotic (SMD 1.40, 95% CI 0.94-1.86), and acupuncture (SMD 1.00, 95% CI 0.39-1.60) had significantly larger effect on stool frequency; acupuncture (RR 1.56, 95% CI 1.14-2.14) had significantly higher responder rate; and moxibustion (SMD 2.50, 95% CI 0.05-4.95) had significant larger effect on Bristol score. Compared with laxative, acupuncture had significantly larger effect on stool frequency (RR 2.01, 95% CI 1.16-3.49) and had lower rate of adverse events (RR 0.38, 95% CI 0.18-0.80). CONCLUSIONS: TENS and acupuncture relatively ranked the best in managing CFC, but the results should be interpreted with caution due to small study effects. Registration number: PROSPERO CRD42014006686.


Asunto(s)
Enfermedades Funcionales del Colon/terapia , Tratamiento Conservador/métodos , Estreñimiento/terapia , Humanos
14.
Neurogastroenterol Motil ; 30(9): e13400, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30062794

RESUMEN

BACKGROUND: In functional gastrointestinal disorders a lack of objective biomarkers limits evaluation of underlying mechanisms. We aimed to demonstrate the utility of magnetic resonance imaging for this task using psyllium, an effective constipation treatment, in patients and controls. METHODS: Two crossover studies: (i) adults without constipation (controls, n = 9) took three treatments in randomized order for 6 days - maltodextrin (placebo), psyllium 3.5 g t.d.s and 7 g t.d.s., (ii) adults with chronic constipation (patients, n = 20) took placebo and psyllium 7 g t.d.s. for 6 days. MRI was performed fasting and postprandially on day 6. Measurements included small bowel and ascending colon water content, colonic volume, transit time, and MR relaxometry (T1, T2) to assess colonic chyme. Stool water percentage was measured. RESULTS: 7 g psyllium t.d.s. increased fasting colonic volumes in controls from median 372 mL (IQR 284-601) to 578 mL (IQR 510-882), and in patients from median 831 mL (IQR 745-934) to 1104 mL (847-1316), P < .05. Mean postprandial small bowel water was higher in controls and patients after 7 g psyllium t.d.s. vs placebo. Whole gut transit was slower in patients than controls (P < .05). T1 of the descending colon chyme (fasting) was lower in patients (213 ms, 176-420) than controls (440 ms, 352-884, P < .05) on placebo, but increased by 7 g psyllium t.d.s. (590 ms, 446-1338), P < .001. Descending colon T1 correlated with baseline stool water content and stool frequency on treatment. CONCLUSIONS AND INFERENCES: MRI measurements can objectively demonstrate the mode of action of therapy targeting intestinal fluid content in constipation.


Asunto(s)
Catárticos/uso terapéutico , Colon/diagnóstico por imagen , Estreñimiento/diagnóstico por imagen , Tránsito Gastrointestinal/efectos de los fármacos , Psyllium/uso terapéutico , Adulto , Colon/efectos de los fármacos , Colon/fisiopatología , Enfermedades Funcionales del Colon/complicaciones , Enfermedades Funcionales del Colon/diagnóstico por imagen , Enfermedades Funcionales del Colon/tratamiento farmacológico , Estreñimiento/tratamiento farmacológico , Estreñimiento/etiología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad
15.
Neurogastroenterol Motil ; 30(9): e13401, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30039585

RESUMEN

BACKGROUND: Using water-perfused (WP) high-resolution manometry, we recently demonstrated that children with functional constipation (FC) lacked the postprandial increase in distal colonic cyclic motor patterns that was observed in healthy adults. Our aim was to determine if similar results could be detected using a solid-state (SS) manometry catheter. METHODS: We performed a retrospective analysis of 19 children with FC (median age 11.1 years, 58% male) who underwent colonic manometry with a SS catheter (36 sensors, 3 cm apart). Data were compared with previously published data using a WP catheter (36 sensors, 1.5 cm apart) recorded from 18 children with FC (median age 15 years; 28% male). KEY RESULTS: The cyclic motor patterns recorded by the SS catheter did not differ from those previously recorded by the WP catheter. There was no detected increase in this activity in response to the meal in either group. Long-single motor patterns were recorded in most patients (n = 16, 84%) with the SS catheter. The number of these events did not differ from the WP recordings. In the SS data, HAPCs were observed in 4 children prior to the meal, in 5 after the meal. This did not differ significantly from the WP data. CONCLUSIONS & INFERENCES: These data recorded by SS manometry did not differ from WP manometry data. Regardless of the catheter used, both studies revealed an abnormal colonic response to a meal, indicating a pathology which is not related to the catheter used to record these data.


Asunto(s)
Colon/fisiopatología , Enfermedades Funcionales del Colon/diagnóstico , Estreñimiento/diagnóstico , Motilidad Gastrointestinal/fisiología , Manometría/instrumentación , Adolescente , Catéteres , Niño , Preescolar , Femenino , Humanos , Masculino , Manometría/métodos , Estudios Retrospectivos , Adulto Joven
16.
Neurogastroenterol Motil ; 30(10): e13394, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-29956418

RESUMEN

While it is generally accepted that gastrointestinal infections can cause functional disturbances in the upper and lower gastrointestinal tract-known as postinfectious irritable bowel syndrome (PI-IBS) and functional dyspepsia (PI-FD)-it has still not been widely recognized that such an infection can also initiate functional non-intestinal diseases, and that non-intestinal infections can provoke both intestinal and non-intestinal functional disturbances. We conducted a scoping review of the respective literature and-on the basis of these data-hypothesize that medically unexplained functional symptoms and syndromes following an infection may have a biological (genetic, endocrine, microbiological) origin, and that psychological and social factors, which may contribute to the disease "phenotype," are secondary to this biological cause. If this holds true, then the search for psychological and social theories and factors to explain why one patient develops a chronic functional disorder while another does not is-at least for postinfectious states-misleading and detracts from exploring and identifying the true origins of these essentially biological disorders. The biopsychosocial model may, as the term implies, always begin with biology, also for functional (somatoform) disorders.


Asunto(s)
Enfermedades Funcionales del Colon/etiología , Enfermedades Gastrointestinales/microbiología , Infecciones/complicaciones , Animales , Humanos
17.
Ugeskr Laeger ; 180(24)2018 Jun 11.
Artículo en Danés | MEDLINE | ID: mdl-29886890

RESUMEN

Many school children complain about recurrent abdominal pain. These children have diminished quality of life, increased school absence and functional disability. Despite the high prevalence and well-documented consequences for patients, their families and society, there is a remarkable lack of evidence-based treatments available. Hypnotherapeutic treatment (HT) has shown promising results. In this review, we discuss current research on HT of these patients. In conclusion, further studies are needed to confirm the effect of HT on functional abdominal pain disorder and to optimise the treatment format.


Asunto(s)
Dolor Abdominal/terapia , Hipnosis , Dolor Abdominal/diagnóstico , Adolescente , Niño , Enfermedades Funcionales del Colon/diagnóstico , Enfermedades Funcionales del Colon/terapia , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
18.
Contemp Clin Trials ; 68: 61-66, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29567283

RESUMEN

PURPOSE: Bowel dysfunction is a common, persistent long-term effect of treatment for rectal cancer survivors. Survivors often use dietary modifications to maintain bowel control. There are few evidence-based interventions to guide survivors on appropriate diet modifications for bowel symptom management. The purpose of this paper is to describe the development and design of the Altering Intake, Managing Symptoms (AIMS) intervention to support bowel dysfunction management in rectal cancer survivors. METHODS: The AIMS intervention is a ten-session, telephone-based diet behavior change intervention delivered by trained health coaches. It uses dietary recall, participant-completed food and symptom diaries, and health coaching guided by motivational interviewing to promote bowel symptom management and improved diet quality. Based on the Chronic Care Self-Management Model (CCM), the AIMS Intervention is designed to improve self-efficacy and self-management of bowel symptoms by coaching survivors to appropriately modify their diets through goal setting, self-monitoring, and problem-solving. The intervention targets survivors with stage I-III rectosigmoid colon/rectum cancer who are 6 months post-treatment, 21 years and older, and English-speaking. CONCLUSIONS: The design and development process described in this paper provides an overview and underscores the potential of the AIMS intervention to positively impact the quality of long-term survivorship for rectal cancer survivors. An ongoing pilot study will inform the design and development of future multi-site Phase II and III randomized trials.


Asunto(s)
Supervivientes de Cáncer , Enfermedades Funcionales del Colon , Neoplasias Colorrectales , Dietoterapia/métodos , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Complicaciones Posoperatorias , Calidad de Vida , Adulto , Supervivientes de Cáncer/psicología , Supervivientes de Cáncer/estadística & datos numéricos , Enfermedades Funcionales del Colon/diagnóstico , Enfermedades Funcionales del Colon/dietoterapia , Enfermedades Funcionales del Colon/etiología , Enfermedades Funcionales del Colon/psicología , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/cirugía , Asesoramiento a Distancia/métodos , Femenino , Humanos , Masculino , Entrevista Motivacional/métodos , Estadificación de Neoplasias , Proyectos Piloto , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/dietoterapia , Complicaciones Posoperatorias/psicología , Autocuidado/métodos , Autocuidado/psicología , Autoeficacia , Evaluación de Síntomas/métodos
19.
J Pediatr Gastroenterol Nutr ; 66(2): 244-249, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28742722

RESUMEN

OBJECTIVES: The aim of the study was to assess the prevalence of attention deficit hyperactivity disorder (ADHD) in children presenting with functional defecation disorders (FDDs) and to assess the prevalence of FDDs in children with ADHD. METHODS: A cross-sectional cohort study was carried out between September 2014 and May 2016. Group 1: Parents of children with FDDs according to the Rome III criteria completed the Child Behavior Checklist and the VvGK (Dutch questionnaire based on the American Disruptive Behavior Disorder rating scale). Patients with ADHD subarea scores ≥70 on the Child Behavior Checklist and/or ≥16 on the VvGK were referred for further psychiatric evaluation. Group 2: Parents of children treated for ADHD at a specialized ADHD outpatient clinic completed a standardized questionnaire regarding their child's defecation pattern. RESULTS: In group 1 (282 children with FDDs), 10.3% (7.1%-13.5% bias-corrected and accelerate confidence interval) were diagnosed with ADHD. Group 2 consisted of 198 children with ADHD, 22.7% (17.6-28.8 bias-corrected and accelerate confidence interval) fulfilled the Rome III criteria for an FDD. Children with both an FDD and ADHD reported urinary incontinence significantly more often compared to children with an FDD or ADHD alone: 57.1% in FDD + ADHD versus 22.8% in FDD alone (P < 0.001) and 31.1% in ADHD + FDD versus 7.8% in ADHD alone (P < 0.001). CONCLUSIONS: Approximately 10.3% of children with FDDs had ADHD and 22.7% of children with a known diagnosis of ADHD fulfilled the Rome III criteria for an FDD. This observation suggests that screening for behavioral disorders and FDDs should be incorporated into the diagnostic workup of these groups of children.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Enfermedades Funcionales del Colon/epidemiología , Adolescente , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Niño , Estudios de Cohortes , Enfermedades Funcionales del Colon/complicaciones , Estudios Transversales , Defecación , Femenino , Humanos , Masculino , Prevalencia , Psicometría/métodos , Encuestas y Cuestionarios
20.
Colorectal Dis ; 19(8): 756-763, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28181378

RESUMEN

AIM: Poor functional results, such as faecal incontinence (FI), low anterior resection syndrome (LARS) or high stool frequency, can occur after colorectal resections, including proctocolectomy with ileal pouch-anal anastomosis (IPAA), rectal resection and left hemicolectomy. Management of such patients is problematic, and some case reports have demonstrated the effectiveness of sacral nerve stimulation (SNS) in these situations. Our aim was to analyse the effectiveness of SNS on poor functional results and on quality of life in patients after treatment with different types of colorectal resection. METHOD: At five university hospitals from 2006 to 2014, patients with poor functional results after rectal resection, IPAA or left hemicolectomy underwent a staged SNS implant procedure. Failure was defined by the absence or insufficient improvement (< 50%) of FI episodes. RESULTS: SNS for bowel dysfunction was performed in 16 patients after rectal resection with coloanal anastomosis, left hemicolectomy with colorectal anastomosis or IPAA. Two (13%) cases of primary failure were observed after the percutaneous stimulation test. Median frequency of stool, FI episodes and urgency were significantly improved in 14 patients. Wexner and LARS scores were also significantly improved for 14 patients. When we compared results according to the type of colorectal surgery (IPAA, rectal resection or left hemicolectomy), median frequencies of stool and urgency, Wexner and LARS scores were still significantly improved. Overall success rate was 75% (12/16 patients) in intention-to-treat analysis and 86% (12/14 patients with permanent electrode) in per-protocol analysis. CONCLUSION: SNS seems to improve bowel dysfunction following rectal resection, left hemicolectomy or IPAA.


Asunto(s)
Colectomía/efectos adversos , Enfermedades Funcionales del Colon/terapia , Plexo Lumbosacro , Complicaciones Posoperatorias , Estimulación Eléctrica Transcutánea del Nervio/métodos , Adulto , Anciano , Anastomosis Quirúrgica/efectos adversos , Colon/cirugía , Enfermedades Funcionales del Colon/etiología , Femenino , Humanos , Análisis de Intención de Tratar , Masculino , Persona de Mediana Edad , Recto/cirugía , Resultado del Tratamiento , Adulto Joven
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