ABSTRACT
BACKGROUND: In contrast to the US and Europe, prevalence and laxative use for self-defined constipation among adults was previously reported to be unassociated with age among adults in South Korea and Brazil. AIM: To determine whether observations in South Korea and Brazil are reflective of other Asian and South American countries. METHODS: A total of 8100 adults from Argentina, Colombia, Indonesia and China completed a questionnaire identical to that previously used in South Korea and Brazil. RESULTS: Prevalence of constipation was similar to that reported for Brazil and South Korea and was 2.17-fold (95% CI: 1.71-2.64) higher amongst women than amongst men. Prevalence increased with age amongst all adults in Argentina and China and only among men in Colombia and Brazil. With the exception of Indonesia, the majority of those with constipation had symptoms at least once weekly, and for < or =3 years. Less than one-third of adults reported using laxatives to treat constipation. Laxative use was not associated with gender and increased with age in Argentina and Colombia. CONCLUSIONS: No clear geographical or cultural tendencies were observed in the prevalence of constipation and laxative use among the South American and Asian countries studied in this survey.
Subject(s)
Constipation/drug therapy , Laxatives/therapeutic use , Adult , Asia/epidemiology , Constipation/epidemiology , Cross-Cultural Comparison , Female , Health Surveys , Humans , Male , Middle Aged , Prevalence , Socioeconomic Factors , South America/epidemiology , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Our purpose was to evaluate visceral sensitivity and psychologic profiles in children with functional gastrointestinal disorders. STUDY DESIGN: We measured visceral perception in the stomach and in the rectum by using an electronic barostat. Psychologic questionnaires were completed. Ten children with recurrent abdominal pain (RAP)(8 female, mean age 11.3 +/- 0.8 years), 10 children with irritable bowel syndrome (IBS) (8 female, mean age 13.0 +/- 0.9 years), and 15 control children (8 female, mean age 12.7 +/- 1.2 years) completed the study. RESULTS: Thresholds for visceral perception in the rectum were decreased in patients with IBS (P <.001 vs control patients) and in patients with RAP (P <.05 vs control patients). Children with IBS had lower thresholds than children with RAP (P <.01). In contrast, thresholds for perception were decreased in the stomach of children with RAP (P <.005 vs control patients) but not in children with IBS. There were elevated anxiety scores in 45% of patients. Duration of symptoms was associated with higher scores of anxiety (P <.001) and depression (P <.02). CONCLUSIONS: Hyperalgesia was demonstrated in children with RAP and IBS; sites of hyperalgesia appear to be associated with different symptom phenotypes; anxiety was common, and there was an association between the duration of symptoms and increased scores for both anxiety and depression.
Subject(s)
Abdominal Pain/physiopathology , Abdominal Pain/psychology , Colonic Diseases, Functional/physiopathology , Colonic Diseases, Functional/psychology , Hyperalgesia/physiopathology , Hyperalgesia/psychology , Viscera/physiopathology , Abdominal Pain/complications , Adolescent , Anxiety Disorders/complications , Anxiety Disorders/physiopathology , Anxiety Disorders/psychology , Child , Colonic Diseases, Functional/complications , Depressive Disorder/complications , Depressive Disorder/physiopathology , Depressive Disorder/psychology , Female , Humans , Hyperalgesia/complications , Male , Pain Measurement , Pain Threshold/physiology , Pain Threshold/psychology , Rectum/physiopathology , Recurrence , Severity of Illness Index , Stomach/physiopathology , Touch/physiologyABSTRACT
The successful management of fecal incontinence requires an understanding of anorectal function, careful delineation of the disorder by a detailed history and physical examination, and specialized studies of anorectal and pelvic floor function in selected patients. These studies include anorectal manometry, dynamic radiographic studies of the anorectum, pelvic floor neurophysiologic tests and anal endosonography. Therapeutic options include dietary modifications, behavioral programs, pharmacologic agents and surgery. Currently available diagnostic tests should result in optimal management of these patients.
Subject(s)
Fecal Incontinence/physiopathology , Fecal Incontinence/therapy , Aged , Anal Canal/physiopathology , Child , Diet , Diphenoxylate/therapeutic use , Enema , Fecal Incontinence/surgery , Female , Humans , Loperamide/therapeutic use , Male , Manometry , Middle Aged , Pelvic Floor/innervation , Pelvic Floor/physiopathology , Radiography , Rectum/diagnostic imaging , Rectum/physiopathologyABSTRACT
In order to evaluate the role of lactose malabsorption in children with recurrent abdominal pain, we performed a prospective controlled double-blinded study in 40 children with RAP of at least three months' duration. Children were studied for lactose malabsorption by breath hydrogen determinations after ingestion of lactose (2 gm/kg of body weight; maximum 50 gm). Lactose malabsorbers were retested with 12.5 gm lactose; lactose absorbers were retested with lactose for ability to produce hydrogen. All children underwent a dietary trial which included two lactose elimination periods. Although 12 children (30%) were lactose malabsorbers, only three malabsorbed part of the smaller, more physiologic, lactose load. Improvement rates of lactose malabsorbers and absorbers during lactose elimination were not significantly different as judged by their physicians and as determined by a 50% or more decrease in pain frequency. These results suggest that lactose malabsorption is of little importance in children with RAP.