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1.
Food Funct ; 14(11): 5264-5276, 2023 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-37194317

RESUMO

Fermented dairy food, such as yogurt, exhibits some beneficial effects on consumers, including alleviating constipation. In this study, Lactobacillus delbrueckii subsp. bulgaricus DPUL-36, Lactobacillus paracasei DPUL-40 and Lactobacillus paracasei DPUL-44 were used as combined starter cultures at a bacterial cell ratio of 1 : 1 : 1 for reconstituted skim milk fermentation. The milk fermented with the combined starter culture showed good sensory properties. During the storage period, the yogurt showed high lactic acid bacteria vitality and quality stability. Constipated BALB/c mice induced by loperamide (Lop) were orally administered with the combined starter culture fermented milk for 14 days. The results clearly showed that oral administration of the fermented milk relieved Lop-induced constipation in the mice, as evidenced by the significantly increased fecal water content, reduced first black stool time, improved gastrointestinal transmission rate, recovered colon tissue damage, increased level of excitatory neurotransmitters (motilin, gastrin, and substance P) and reduced level of inhibitory neurotransmitters (vasoactive intestinal peptide, somatostatin and endothelin-1) of the mice. Compared with the mice in the Lop group, oral administration of the fermented milk significantly increased the concentrations of acetic acid, propionic acid, butyric acid, isovaleric acid and valeric acid in the feces of the mice, and furthermore, exerted a regulatory effect on the gut microbiota of the mice by up-regulating the abundance of Lactobacillus and Bacteroides, and decreasing the abundance of Helicobacter, Pseudomonas and Porphyromonas. Our results indicated that the combined starter culture fermented milk can effectively alleviate Lop-induced-constipation in BALB/c mice. The relationship between the nutrient profiles and the health promoting function of the yogurt should be further illustrated.


Assuntos
Constipação Intestinal , Lactobacillus , Iogurte , Animais , Camundongos , Masculino , Camundongos Endogâmicos BALB C , Fermentação , Constipação Intestinal/induzido quimicamente , Constipação Intestinal/dietoterapia , Loperamida/toxicidade , Iogurte/microbiologia , Microbioma Gastrointestinal
3.
Evid. actual. práct. ambul ; 26(4): e007069, 2023. ilus, tab
Artigo em Espanhol | BINACIS, UNISALUD, LILACS | ID: biblio-1526537

RESUMO

A partir del caso de una paciente con síndrome de intestino irritable a predominio de estreñimiento cuyos síntomas mejoraron con el consumo regular de kiwi, el médico de familia se planteó la pregunta de si el kiwi podría mejorar los síntomas asociados a constipación crónica en comparación con el tratamiento habitual. Tras realizar una búsqueda de estudios que analizaran los efectos del consumo de kiwi sobre el hábito intestinal, fueron seleccionados tres artículos que permiten concluir que el consumo de esta fruta tiene una eficacia superior al placebo y comparable al psyllium y las pasas de ciruela para mejorar los síntomas de personas con estreñimiento crónico. (AU)


Based on the case of a patient with constipation-predominant irritable bowel syndrome whose symptoms improved with regular consumption of kiwi, the family doctor wondered if kiwi could improve symptoms associated with chronic constipation compared to usual treatment. After conducting a search for studies that analyzed the effects of kiwi consumption on intestinal habit, three articles were selected that allow us to conclude that the consumption of this fruit has an efficacy superior to placebo and comparable to psyllium and plum raisins to improve the symptoms of people with chronic constipation. (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Constipação Intestinal/dietoterapia , Síndrome do Intestino Irritável/dietoterapia , Frutas , Psyllium/uso terapêutico , Dor Abdominal/dietoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Constipação Intestinal/diagnóstico , Actinidia , Síndrome do Intestino Irritável/diagnóstico , Fezes , Revisões Sistemáticas como Assunto
4.
Nutrients ; 13(12)2021 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-34960021

RESUMO

Constipation is a frequent complication in patients with severe motor and intellectual disabilities (SMID). The aim of this study was to investigate changes in constipation symptoms and gut microbiota associated with the intake of malted rice amazake, a fermented food in Japan, in patients with SMID. Ten patients consumed the test food for six weeks, and their physical condition, dietary and medication status, and constipation assessment scale (CAS) were investigated. Comprehensive fecal microbiome analysis using the 16S rRNA sequence method was performed. The results showed a significant decrease in CAS, and a significant increase in Lactobacillales and decrease in Escherichia-Shigella after consuming malted rice amazake. To investigate the difference in the effects of malted rice amazake consumption, based on the characteristics of the original gut microbiota, the patients were grouped according to the similarity of their gut microbiota before the intervention; Firmicutes-rich Group 1 (n = 5), Actinobacteria-rich Group 2 (n = 4), and Proteobacteria-rich Group 3 (n = 1). The CAS decreased in Groups 1 and 2. The relative abundance of Bifidobacterium showed an increasing tendency both overall and in Group 1, but it was originally higher in Group 2. Our results suggest that malted rice amazake consumption reduces constipation symptoms and simultaneously changes the gut microbiota, but the changes may vary depending on the original composition of the gut microbiota.


Assuntos
Constipação Intestinal/dietoterapia , Pessoas com Deficiência , Microbioma Gastrointestinal/efeitos dos fármacos , Deficiência Intelectual , Oryza , Plântula , Adulto , Bactérias/efeitos dos fármacos , Bactérias/genética , Criança , Fezes/microbiologia , Feminino , Humanos , Masculino , Projetos Piloto , RNA Bacteriano , RNA Ribossômico 16S
5.
Am J Gastroenterol ; 116(6): 1304-1312, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074830

RESUMO

INTRODUCTION: Psyllium and prunes are proven treatments for chronic constipation (CC). Asian studies suggest that kiwifruit may also benefit CC symptoms. We report a partially randomized, comparative effectiveness trial evaluating kiwifruit, psyllium, and prunes in US patients with CC. METHODS: Adults with CC at a US medical center were randomized to 3 natural treatments. Eligible patients had ≤3 complete spontaneous bowel movements (CSBMs) per week and were partially randomized to green kiwifruit (2/d), prunes (100 g/d), or psyllium (12 g/d) for 4 weeks. The primary endpoint was the proportion of patients in each group reporting an increase of ≥1 CSBM per week compared with baseline for at least 2 of 4 treatment weeks. Key secondary outcomes included stool frequency, stool consistency, and straining assessed daily. Treatment satisfaction and adverse events (AEs) were also measured. Standard statistical methods were used, and a P < 0.05 was considered significant. RESULTS: Seventy-nine patients with CC (mean age = 42.7 years, 87% female, and 77% white) were partially randomized. Complete data were available for 75 patients (kiwifruit 29, prunes 24, and psyllium 22). For the primary endpoint, proportions of CSBM responders were similar for the treatments. For secondary outcomes comparing treatment weeks 3 and 4 to baseline, there was a significant increase in weekly CSBM rate with all 3 treatments (P ≤ 0.003); stool consistency significantly improved with kiwifruit (P = 0.01) and prunes (P = 0.049); and straining significantly improved with kiwifruit (P = 0.003), prunes (P < 0.001), and psyllium (P = 0.04). Patients randomized to the kiwifruit group reported significant improvement in bloating scores (P = 0.02). AEs were most common with psyllium and least common with kiwifruit. At the end of treatment, a smaller proportion of patients were dissatisfied with kiwifruit compared with prunes or psyllium (P = 0.02). DISCUSSION: Kiwifruit, prunes, and psyllium improve constipation symptoms in patients with CC. Kiwifruit was associated with the lowest rate of AEs and dissatisfaction with therapy.


Assuntos
Constipação Intestinal/dietoterapia , Frutas , Psyllium/uso terapêutico , Actinidia , Adulto , Doença Crônica , Pesquisa Comparativa da Efetividade , Feminino , Humanos , Masculino , Prunus
6.
Nutrients ; 13(5)2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-34067961

RESUMO

Constipation is a frequent problem in children. We evaluated the effect of a mixture (polydextrose [PDX] and fructooligosaccharide [FOS]) in children with constipation. We performed a prospective interventional study with a mixture (PDX 4.17 g and FOS 0.45 g) in a daily dose of food supplement. The intervention lasted 45 days, with visits at 15, 30, and 45 days after administration. The sample comprised 105 patients, of whom 77 completed the intervention. A statistically significant reduction in the frequency of symptoms was observed at the end of the study. The frequency of children with fewer than three bowel movements per week dropped from 59.7% to 11.7%, and there was a decrease in the frequency of Bristol type 1 and 2 dry stools (68.8% to 7.8%), pain on defecation (79.2% to 10.4%), and fear of defecation (68.8% to 3.9%). The proportion of children with abdominal pain symptoms decreased from 84.2% to 2.6% at the end of the study. A relevant limitation of the present study was the lack of a control group treated with placebo. The administration of the PDX/FOS mixture was accompanied by a significant reduction in the frequency of constipation symptoms of the children evaluated. The tolerability was very good, and the rate of adverse effects was low.


Assuntos
Constipação Intestinal/dietoterapia , Suplementos Nutricionais , Glucanos/uso terapêutico , Oligossacarídeos/uso terapêutico , Criança , Pré-Escolar , Fibras na Dieta/administração & dosagem , Fibras na Dieta/uso terapêutico , Quimioterapia Combinada , Feminino , Glucanos/administração & dosagem , Humanos , Masculino , Oligossacarídeos/administração & dosagem
7.
Allergol Immunopathol (Madr) ; 49(3): 17-20, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33938184

RESUMO

Functional constipation (FC) is one of the most common disorders in childhood and has a negative impact on the quality of life of children. Scientific evidence regarding a causal relationship between FC and cow's milk allergy is controversial, as it is also reported by the latest European Society for Paediatric Gastroenterology, Hepatology and Nutrition-North American Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN-NASPGHAN) recommendations. In the case of FC, routine allergometric tests are not recommended and the cows' milk-free diet is only proposed in the case of laxative-resistant constipation and only following the advice of an expert. Instead, after a careful review of the literature and in view of the many clinical cases encountered in our clinical practice, we believe that it is useful to propose cows' milk-free diet as first line for the treatment of FC at least in pre-school children and in children with a personal or family history of atopy or with a previous diagnosis of cow's milk protein allergy.


Assuntos
Constipação Intestinal/dietoterapia , Hipersensibilidade a Leite/complicações , Leite/efeitos adversos , Animais , Criança , Pré-Escolar , Constipação Intestinal/etiologia , Resistência a Medicamentos , Feminino , Guias como Assunto , Humanos , Laxantes/uso terapêutico , Masculino , Proteínas do Leite/administração & dosagem , Proteínas do Leite/efeitos adversos , Qualidade de Vida
8.
Allergol. immunopatol ; 49(3): 17-20, mayo 2021. ilus
Artigo em Inglês | IBECS | ID: ibc-214261

RESUMO

Functional constipation (FC) is one of the most common disorders in childhood and has a negative impact on the quality of life of children. Scientific evidence regarding a causal relationship between FC and cow’s milk allergy is controversial, as it is also reported by the latest European Society for Paediatric Gastroenterology, Hepatology and Nutrition-North American Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN–NASPGHAN) recommendations. In the case of FC, routine allergometric tests are not recommended and the cows’ milk-free diet is only proposed in the case of laxative-resistant constipation and only following the advice of an expert. Instead, after a careful review of the literature and in view of the many clinical cases encountered in our clinical practice, we believe that it is useful to propose cows’ milk-free diet as first line for the treatment of FC at least in pre-school children and in children with a personal or family history of atopy or with a previous diagnosis of cow’s milk protein allergy (AU)


Assuntos
Humanos , Feminino , Criança , Hipersensibilidade a Leite/complicações , Constipação Intestinal/dietoterapia , Constipação Intestinal/etiologia , Qualidade de Vida , Guias de Prática Clínica como Assunto , Resistência a Medicamentos , Laxantes/uso terapêutico
9.
Nutrients ; 13(4)2021 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-33800620

RESUMO

BACKGROUND: Elimination of gluten-containing cereals and consumption of ultra-processed gluten-free foods might cause an unbalanced diet, deficient in fiber and rich in sugar and fat, circumstances that may predispose celiac children to chronic constipation. AIM: to evaluate if counseling with a registered dietitian (RD) was capable of improving eating and bowel habits in a celiac pediatric population. METHODS: Dietetic, lipid profile and stool modifications were analyzed, comparing baseline assessments with those twelve months after receiving heathy eating and nutrition education sessions. At both time points, 3-day food records, a bowel habit record and a lipid panel were conducted. Calculated relative intake of macro- and micro-nutrients were compared with current recommendations by the European Food Safety Authority (EFSA). Student's paired t-test, McNemar test, Mandasky test and Pearson correlation tests were used. RESULTS: Seventy-two subjects (58.3% girls) with a mean (standard deviation (SD)) age of 10.2 (3.4) years were included. Baseline diets were imbalanced in macronutrient composition. Significant improvements were observed in their compliance with dietary reference values (DRVs), where 50% of the subjects met fat requirements after the education and 67% and 49% with those of carbohydrates and fiber, respectively (p < 0.001). Celiac children decreased red meat and ultra-processed foods consumption (p < 0.001) and increased fruits and vegetables intake (p < 0.001), leading to a reduction in saturated fat (p < 0.001) and sugar intake (p < 0.001). Furthermore, 92% of the patients achieved a normal bowel habit, including absence of hard stools in 80% of children constipated at baseline (p < 0.001). CONCLUSIONS: RD-led nutrition education is able to improve eating patterns in children with celiac disease (CD).


Assuntos
Doença Celíaca/dietoterapia , Constipação Intestinal/dietoterapia , Aconselhamento/métodos , Dieta Livre de Glúten/métodos , Educação de Pacientes como Assunto/métodos , Adolescente , Doença Celíaca/complicações , Criança , Pré-Escolar , Constipação Intestinal/etiologia , Dieta Livre de Glúten/psicologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Lactente , Masculino , Estado Nutricional , Cooperação do Paciente/psicologia , Avaliação de Resultados da Assistência ao Paciente , Estudos Prospectivos
10.
Nutrients ; 13(2)2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33673062

RESUMO

A gluten-free diet (GFD) leads to a rapid improvement in gastrointestinal (GI) symptoms, biochemical alterations and duodenal histological damage in the majority of celiac disease (CD) patients. This study aimed to assess the frequency and factors associated with the persistence of GI symptoms/malabsorption signs and their relationship with duodenal histological findings among CD patients on an adequate GFD (mean duration 16 months, range 12-28 months). This longitudinal cohort study included 102 adult CD patients (median age 38.5 years, range 18-76 years, F = 71.6%) diagnosed between 2012 and 2018. A total of 36.3% of the included patients had persistent GI symptoms and/or malabsorption signs (Group 1), while the remaining patients had complete GI well-being without malabsorption signs (Group 2) at the time of histological re-evaluation. The persistence of GI symptoms/signs was associated with a long duration of symptoms/signs before CD diagnosis (≥5 years) (OR 5.3; 95% CI 1.3-21.8) and the presence of constipation at the time of CD diagnosis (OR 7.5; 95% CI 1.3-42) while for other variables, including age at CD diagnosis, sex, duration of GFD, comorbidities, CD serology positivity and severity of duodenal damage at histological re-evaluation, no association was found. According to our results, the persistence of symptoms/signs is not associated with histological findings, and their relationship could be a gray area in CD management.


Assuntos
Doença Celíaca/dietoterapia , Doença Celíaca/patologia , Dieta Livre de Glúten , Duodeno/patologia , Cooperação do Paciente , Adolescente , Adulto , Idoso , Doença Celíaca/complicações , Constipação Intestinal/dietoterapia , Constipação Intestinal/etiologia , Constipação Intestinal/patologia , Gerenciamento Clínico , Feminino , Humanos , Absorção Intestinal , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Avaliação de Sintomas , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
11.
Expert Rev Gastroenterol Hepatol ; 15(6): 583-587, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33522316

RESUMO

Introduction: Functional gastrointestinal disorders (FGIDs) are common in children and incur high direct and indirect social costs. Partially hydrolyzed guar gum (PHGG) is a natural and water-soluble dietary fiber that is derived from guar gum. It has been proposed as complementary therapy in pediatric FGIDs, especially in chronic functional constipation and irritable bowel syndrome.Areas covered: By focusing on four clinical cases, this article illustrates the use of PHGG fiber as sole supplement ingredient or as a formula component in orally- and tube-fed children suffering from malnutrition due to FGIDs, with or without special medical conditions such as neurological disability. The formula used was a whey peptide-based nutritionally complete formula containing PHGG as a source of soluble dietary fiber. It was offered under medical supervision and after full consideration of all feeding options.Expert opinion: Implementing appropriate feeding behaviors, adapted to age and potential comorbidities, is an essential requisite for therapeutic management of FGIDs. The use of a PHGG supplement or a nutritionally complete formula containing PHGG as a source of soluble dietary fiber can be helpful to manage pediatric FGIDs.


Assuntos
Constipação Intestinal/dietoterapia , Fibras na Dieta/uso terapêutico , Incontinência Fecal/dietoterapia , Galactanos/uso terapêutico , Síndrome do Intestino Irritável/dietoterapia , Mananas/uso terapêutico , Gomas Vegetais/uso terapêutico , Criança , Pré-Escolar , Doença Crônica , Feminino , Alimentos Formulados , Humanos , Lactente , Masculino
12.
Carbohydr Polym ; 256: 117418, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33483010

RESUMO

Constipation is one of the most prevalent gastrointestinal tract diseases. Konjac glucomannan (KGM) dietotherapy can effectively relieve the clinical symptoms of patients with constipation. However, the causal relationship among KGM, constipation and different gastrointestinal microbiome (i.e., the stomach {St}, small intestine {S}, and large intestine {L}) remains poorly understood. In this study, constipated mice were treated with KGM (75, 150, 300 mg/kg bw). Results showed that KGM treatment improved the general physiological state, fecal character, small intestinal propulsive rate, gastric emptying rate, MTL and AchE activities, ET-1, 5-HT, and NO levels, and SCFA concentrations. KGM in the diets of constipated mice reduced the diversity of St and S microbiota, while increased those in the L. The KGM intervention regulated the microbiota profile, which afterwards was closer to the normal mouse group: confirmation was provided by different changes of bacteria like Lactobacillus, Bifidobacterium and Allobaculum spp et al.


Assuntos
Constipação Intestinal/prevenção & controle , Microbioma Gastrointestinal/efeitos dos fármacos , Loperamida/efeitos adversos , Mananas/farmacologia , Ração Animal , Animais , Bactérias , Bifidobacterium , Constipação Intestinal/induzido quimicamente , Constipação Intestinal/dietoterapia , DNA/análise , Fezes , Feminino , Glicosídeos/química , Lactobacillus , Mananas/química , Manose/química , Camundongos , Neurotransmissores/sangue , Polímeros/química , Probabilidade , Solubilidade
13.
J Ren Nutr ; 31(1): 85-89, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32863164

RESUMO

OBJECTIVES: Constipation is a multifactorial gastrointestinal disorder commonly found in hemodialysis (HD) patients. In this multicenter cross-sectional study, we aimed to evaluate the prevalence and factors associated with constipation, including the frequency of dietary fiber intake. METHODS: HD patients from 4 dialysis clinics were invited. Participants answered a questionnaire which included Roma IV criteria to assess constipation status, use of medications, and lifestyle habits. A food frequency questionnaire with 7 response options on the main dietary fiber sources (fruits, vegetables, legumes, whole grains, and seeds) was also applied. Answers were transformed into a score to estimate the weekly intake frequency, and every score point corresponded to one time per week. Demographical and laboratory data were obtained from medical records. Univariate analysis was used to compare participants according to constipation status, and variables with P < .20 were included in the regression analysis model. RESULTS: Three hundred five HD patients were included (male: 51%; age: 52.2 ± 14.7 years old; HD vintage: 46 (19-82) months). Ninety-three participants had constipation (30.5%). Median (interquartile) food frequency questionnaire scores were as follows: fruits: 6 (2-14); vegetables: 6 (3-10); legumes: 3 (1-7); whole grain: 0 (0-1); and seeds: 0 (0-0). In univariate analysis, participants with constipation were significantly older, had lower literacy, higher prevalence of diabetes, and lower total beverage intake. The logistic regression analysis model also included body mass index, wheelchair need, sedentarism, fruits score, and seeds score (all with P < .20 in the univariate analysis). The independent predictors of constipation were diabetes (odds ratio = 1.96, 95% confidence interval 1.07-3.6, P = .03) and fruits intake score (odds ratio = 0.95, 95% confidence interval 0.91-0.99, P = .04). CONCLUSIONS: Almost one-third of the participants had constipation. The independent determinants of constipation were diabetes and lower frequency of fruit intake. Nutritional counseling to increase fiber intake can potentially decrease the prevalence of constipation in this population.


Assuntos
Constipação Intestinal/dietoterapia , Dieta/métodos , Frutas , Diálise Renal/efeitos adversos , Constipação Intestinal/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
14.
Nat Rev Gastroenterol Hepatol ; 18(2): 101-116, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33208922

RESUMO

Epidemiological studies have consistently demonstrated the benefits of dietary fibre on gastrointestinal health through consumption of unrefined whole foods, such as wholegrains, legumes, vegetables and fruits. Mechanistic studies and clinical trials on isolated and extracted fibres have demonstrated promising regulatory effects on the gut (for example, digestion and absorption, transit time, stool formation) and microbial effects (changes in gut microbiota composition and fermentation metabolites) that have important implications for gastrointestinal disorders. In this Review, we detail the major physicochemical properties and functional characteristics of dietary fibres, the importance of dietary fibres and current evidence for their use in the management of gastrointestinal disorders. It is now well-established that the physicochemical properties of different dietary fibres (such as solubility, viscosity and fermentability) vary greatly depending on their origin and processing and are important determinants of their functional characteristics and clinical utility. Although progress in understanding these relationships has uncovered potential therapeutic opportunities for dietary fibres, many clinical questions remain unanswered such as clarity on the optimal dose, type and source of fibre required in both the management of clinical symptoms and the prevention of gastrointestinal disorders. The use of novel fibres and/or the co-administration of fibres is an additional therapeutic approach yet to be extensively investigated.


Assuntos
Fibras na Dieta/metabolismo , Microbioma Gastrointestinal , Trânsito Gastrointestinal , Mucosa Intestinal/metabolismo , Micronutrientes/metabolismo , Disponibilidade Biológica , Constipação Intestinal/dietoterapia , Diarreia/dietoterapia , Fibras na Dieta/uso terapêutico , Doenças Diverticulares/dietoterapia , Fermentação , Humanos , Doenças Inflamatórias Intestinais/dietoterapia , Síndrome do Intestino Irritável/dietoterapia , Prebióticos , Solubilidade , Viscosidade
15.
Arch. argent. pediatr ; 118(5): 350-357, oct 2020. tab, ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1122544

RESUMO

La enfermedad de Hirschsprung ocurre en 1 de cada 5000 nacimientos. La falla de migración de las células ganglionares desde la cresta neural en dirección cefalocaudal genera su ausencia en parte o todo el colon. Se manifiesta con falta de eliminación de meconio, distensión abdominal y dificultades en la evacuación. Luego del tratamiento quirúrgico, existen complicaciones a corto y largo plazo. El objetivo de esta publicación es describir las principales causas de síntomas persistentes en los pacientes operados por enfermedad de Hirschsprung y presentar un algoritmo diagnóstico-terapéutico factible de ser realizado en nuestro medio


Hirschsprung disease is characterized by the lack of migration of intrinsic parasympathetic ganglia from neural crest and consequently absence of them at varying length of the bowel, resulting in functional obstruction. The incidence is 1 per 5000 births. After surgery, short term and long term comorbidity commonly occurs. The aim of this article is to revise the main causes of ongoing symptoms after surgery in Hirschsprung disease patients and to show a diagnostic and therapeutic algorithm that can be developed in our community


Assuntos
Humanos , Doença de Hirschsprung/cirurgia , Doença de Hirschsprung/diagnóstico , Doença de Hirschsprung/terapia , Pediatria , Doença Crônica , Constipação Intestinal/dietoterapia , Constipação Intestinal/etiologia , Enterocolite/dietoterapia , Enterocolite/etiologia , Incontinência Fecal/dietoterapia , Incontinência Fecal/etiologia
16.
J Food Sci ; 85(10): 3570-3576, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32885419

RESUMO

Okara is a byproduct of soymilk manufacturing and a rich source of protein and dietary fiber. We investigated whether okara intake improves the habit of defecation in young Japanese women (n = 52) with self-reported constipation. Subjects were categorized into placebo and test groups, who ingested soymilk (0.1 g fiber/meal) and okara (4.1 g fiber/meal) soups, respectively, every day for breakfast, for 2 weeks. Subjects' body composition, bowel movement frequency per week, and constipation assessment scale (CAS) and brief-type self-administered diet history questionnaire scores were assessed at baseline and after the intervention (Analysis 1). Further, subjects' bowel movement frequency per week and CAS scores were assessed during the 2-week follow-up (Analysis 2). There were no significant differences in age, anthropometric characteristics, nutrients intake, frequency of bowel movements per week, and total CAS scores between the placebo and test groups at baseline. After intervention, the total CAS score was significantly lower in the test group than in the placebo group. Moreover, the difference in the total CAS scores between baseline and after intervention was lower in the test group than in the placebo group, although not significant. The weekly frequency of bowel movement significantly increased for both placebo and test groups. The test group reported reduced abdominal bloating 2 weeks after the intervention, but the placebo group did not. The findings suggest that okara is effective in increasing the frequency of bowel movements and improving defecation habit in young women with self-reported constipation. PRACTICAL APPLICATION: Okara is an effective food to increase the frequency of bowel movements and to improve defecation habits in young women with self-reported constipation.


Assuntos
Constipação Intestinal/dietoterapia , Defecação , Proteínas de Plantas/metabolismo , Polissacarídeos/metabolismo , Adulto , Desjejum , Constipação Intestinal/metabolismo , Constipação Intestinal/fisiopatologia , Fibras na Dieta/análise , Fibras na Dieta/metabolismo , Método Duplo-Cego , Feminino , Humanos , Japão , Proteínas de Plantas/química , Polissacarídeos/química , Autorrelato , Alimentos de Soja , Adulto Jovem
17.
Nutrients ; 12(8)2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32785036

RESUMO

Metabolic syndrome (MS) affects up to 40% of the population and is associated with heart failure, stroke and diabetes. Phytosterols (PS) could help to manage one or more MS criteria. The purpose of this study was to evaluate the therapeutic effect of daily supplementation of an aqueous dispersion of 2 g of free-phytosterols nanoparticles in individuals with MS over six months of intervention, compared with placebo. This double-blind study included 202 participants with MS randomly assigned into phytosterol (n = 102) and placebo (n = 100) groups. Participants were assessed at baseline, 4, 12 and 24 weeks. General health questions, anthropometric measurements and blood parameters were analysed. At week 24, the proportion of participants with high triglycerides (≥150 mg/dL) in the phytosterol group was 15.65% lower than in the placebo group (p-value = 0.023). Similarly, half of the participants in the phytosterol group decreased their waist circumference up to 4 cm compared with 0 cm in the placebo group (p-value = 0.0001). We reported no adverse effects (diarrhoea or vitamin D reduction); nonetheless, almost 70% of participants in the phytosterol group self-reported an improvement in bowel habits. Daily intake of free-PS nanoparticles improved some MS criteria; therefore, it might be a promising adjuvant therapy for individuals with MS (NCT02969720).


Assuntos
Suplementos Nutricionais , Síndrome Metabólica/dietoterapia , Nanopartículas , Fitosteróis/administração & dosagem , Fitoterapia , Triglicerídeos/sangue , Circunferência da Cintura , Adolescente , Adulto , Idoso , Constipação Intestinal/dietoterapia , Método Duplo-Cego , Feminino , Humanos , Masculino , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Água , Adulto Jovem
18.
Kobe J Med Sci ; 66(1): E12-E21, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32814753

RESUMO

Hemodialysis patients often become constipated. We analyzed the effect of prebiotics on the defecation status due to the intestinal environment in hemodialysis patients. Fifteen patients received prebiotics as partially hydrolyzed guar gum for four weeks. The defecation status was assessed using both the Bristol Stool Form Scale and the Japanese version of the Constipation Assessment Scale. The fecal status, microbiota measured by a terminal restriction fragment length polymorphism analysis, and fecal short-chain fatty acid concentrations by gas chromatography were compared before and after prebiotics ingestion. Prebiotics ingestion improved the individual stool form and decreased the constipation score from 5.1 to 3.0. The ratio of short-chain fatty acid-producing microbiota, such as Bifidobacterium and Bacteroides, increased after ingestion (2.35- and 3.17-fold, respectively). Furthermore, the concentration of short-chain fatty acids significantly increased (1.58-fold). The individual dendrogram distribution after ingestion was changed in 8 participants (53.3% of the subjects). In 5 participants (33.3% of the subjects), the clusters were even more noticeably different. Prebiotics improved the defecation status in hemodialysis patients due in part to the composition of intestinal microbiota and short-chain fatty acid concentrations.


Assuntos
Constipação Intestinal/dietoterapia , Ácidos Graxos Voláteis/metabolismo , Microbioma Gastrointestinal/fisiologia , Prebióticos , Diálise Renal/efeitos adversos , Adulto , Idoso , Biomarcadores/metabolismo , Cromatografia Gasosa , Constipação Intestinal/etiologia , Constipação Intestinal/metabolismo , Constipação Intestinal/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
19.
Gastroenterol Clin North Am ; 49(3): 607-621, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32718573

RESUMO

Irritable bowel syndrome (IBS) is probably the most common diagnosis in gastroenterology involving the brain-gut axis. By definition, pain is the most frequent symptom experienced by patients. It is important to understand the biopsychosocial and physiologic aspects of the disease when discussing treatment of IBS. Such therapies as lifestyle modifications, changes in diet, and cognitive behavioral therapy should be used in conjunction with pharmacotherapy rather than pharmacotherapy alone. The pathophysiologic mechanisms are reviewed in this article along with the current treatments available, in the era of growing demand for more effective treatments for the pain component of IBS.


Assuntos
Dor Abdominal/terapia , Síndrome do Intestino Irritável/terapia , Dor Abdominal/tratamento farmacológico , Dor Abdominal/etiologia , Doença Crônica , Terapias Complementares/métodos , Constipação Intestinal/dietoterapia , Constipação Intestinal/etiologia , Constipação Intestinal/terapia , Diarreia/tratamento farmacológico , Diarreia/etiologia , Diarreia/terapia , Dietoterapia , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/tratamento farmacológico , Probióticos/administração & dosagem , Recidiva , Fatores de Tempo
20.
Clin Nutr ; 39(12): 3750-3755, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32471645

RESUMO

Zymomonas mobilis have characteristics that classify it as probiotic. Thus, this study aimed to evaluate the effect of regular consumption of fermented broth of this strain on the intestinal function of individuals with changes in intestinal transit. This is a randomized, descriptive and quantitative clinical trial, a sample composed of undergraduate students from a university center in Caruaru. After screening for individuals with constipation according to the inclusion and exclusion criteria, only 13 agreed to participate in the study. They were divided into groups: group 1 received Zymomonas mobilis fermented broth once a day; group 2 also received the fermented broth in the same concentration cells being twice a day; group 3 received cell-free fermented broth once daily; and group 4, placebo, received saline once daily, all groups drank for fifteen days, and laboratory tests were performed to check lipid profile before and after that period. Observed an increase in evacuation days in all groups averaged in media 7.0-10.5 days. Groups 1 and 2 showed an increase in total cholesterol (0.5% and 5.0%, respectively), HDL cholesterol (4.1% and 24.1%), LDL cholesterol (4.9% and 8.4%), VLDL cholesterol (17.9% and 11.2%) and triglycerides (19.1% and 27.9%). In group 3, there was a reduction of total cholesterol (-2.4%), LDL cholesterol (-11.2%), VLDL cholesterol (-15.9%), triglycerides (-27.7%) and increase in HDL cholesterol (25.7%). Thus, the broth fermented with Zymomonas mobilis regulated the intestinal transit, but did not improve the lipid profile, while the without cells broth showed a better lipid profile.


Assuntos
Colesterol/sangue , Constipação Intestinal/dietoterapia , Alimentos Fermentados , Probióticos/administração & dosagem , Zymomonas , Adolescente , Adulto , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Constipação Intestinal/microbiologia , Constipação Intestinal/fisiopatologia , Feminino , Trânsito Gastrointestinal/fisiologia , Humanos , Masculino , Estudantes , Triglicerídeos/sangue , Adulto Jovem
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