Estreñimiento

  1. A.J. Abraldes Bechiarelli 1
  2. M.T. Ramos-Clemente 1
  3. P. Pérez Guerrero 2
  4. C. Rodríguez Ramos 1
  1. 1 Unidad Clínica de Gestión de Aparato Digestivo
  2. 2 Hospital Universitario Puerta del Mar. Cádiz España
Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2016

Issue Title: Enfermedades del aparato digestivo (VII) Enfermedades del tubo digestivo. Intestino delgado y grueso

Series: 12

Issue: 7

Pages: 337-345

Type: Article

DOI: 10.1016/J.MED.2016.03.010 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Introduction Constipation is a common symptom that can sometimes significantly affect the quality of life, and the patient may report as fewer stools, increased consistency, difficult to expel stool or feeling of incomplete evacuation. Aetiopathogenesis It is important to first identify related diseases or probable precipitating factors whose treatment or correction will be important for favorable evolution. Diagnosis In case of chronic idiopathic constipation must be established if colonic transit is normal, slow or if there is dysfunction of the muscles involved in defecation, as therapeutic measures may differ from case to case. Treatment In recent years, in addition to the initial measures of nutritional education and health habits, diet rich in fiber and laxatives, they have emerged drugs with different mechanisms of action that have demonstrated efficacy in refractory cases. Surgical treatment is reserved for highly selected cases of patients with intolerance or lack of response to the wide therapeutic arsenal available, and in each case it is necessary to individually evaluate the risks and benefits.

Bibliographic References

  • Shah BJ, Rughwani N, Rose S. In the clinic. Constipation. Ann Intern Med. 2015;162(7):ITC1.
  • Schmidt FM, Santos VL. Prevalence of constipation in the general adult population: an integrative review. J Wound Ostomy Continence Nurs. 2014;41(1):70-6.
  • Leung L, Riutta T, Kotecha J, Rosser W. Chronic constipation: an evidence-based review. J Am Board Fam Med. 2011;24(4):436-51.
  • Basilisco G, Coletta M. Chronic constipation: a critical review. Dig Liver Dis. 2013;45(11):886-93.
  • Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: a clinical review. JAMA. 2015;313(9):949-58.
  • Chiarelli P, Brown W, McElduff P. Constipation in Australian women: prevalence and associated factors. Int Urogynecol J Pelvic Floor Dys-funct. 2000;11(2):71-8.
  • Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, Stoa JM. Chronic constipation in the elderly. Am J Gastroenterol. 2012;107(1):18-25.
  • Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99(4):750-9.
  • Muller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005;100(1): 232-42.
  • Markland AD, Palsson O, Goode PS, Burgio KL, Busby-Whitehead J, Whitehead WE. Association of low dietary intake of fiber and liquids with constipation: evidence from the National Health and Nutrition Exa-mination Survey. Am J Gastroenterol. 2013;108(5):796-803.
  • Rao SS, Meduri K. What is necessary to diagnose constipation? Best Pract Res Clin Gastroenterol. 2011;25(1):127-40.
  • Tantiphlachiva K, Rao P, Attaluri A, Rao SS. Digital rectal examination is a useful tool for identifying patients with dyssynergia. Clin Gastroenterol Hepatol. 2010;8(11):955-60.
  • Saad RJ, Rao SS, Koch KL, Kuo B, Parkman HP, McCallum RW, et al. Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls. Am J Gastroenterol. 2010;105(2):p.403-11.
  • He CL, Burgart L, Wang L, Pemberton J, Young-Fadok T, Szurszewski J, et al. Decreased interstitial cell of cajal volume in patients with slow-transit constipation. Gastroenterology. 2000;118(1):14-21.
  • Jamshed N, Lee ZE, Olden KW. Diagnostic approach to chronic consti-pation in adults. Am Fam Physician. 2011;84(3):p. 299-306.
  • Rao SS, Ozturk R, Laine L. Clinical utility of diagnostic tests for consti-pation in adults: a systematic review. Am J Gastroenterol. 2005;100(7): 1605-15.
  • American College of Gastroenterology Chronic Constipation Task Force. An evidence-based approach to the management of chronic constipation in North America. Am J Gastroenterol. 2005;100Suppl1:S1-4.
  • Lacima G, Serra J, Mínguez M, Accarino A. Tratado de neurogastroente-rología y motilidad digestiva. Madrid: Editorial Médica Panamericana; 2015. p. 729.
  • Camilleri M, Thorne NK, Ringel Y, Hasler WL, Kuo B, Esfandyari T, et al. Wireless pH-motility capsule for colonic transit: prospective comparison with radiopaque markers in chronic constipation. Neurogastroenterol Motil. 2010;22(8):874-82, e233.
  • Rao SS, Sadeghi P, Beaty J, Kavlock R. Ambulatory 24-hour colonic ma-nometry in slow-transit constipation. Am J Gastroenterol. 2004;99(12):2405-16.
  • Rao SS, Hatfield R, Soffer E, Rao S, Beaty J, Conklin JL. Manometric tests of anorectal function in healthy adults. Am J Gastroenterol. 1999;94(3):773-83.
  • Jones MP, Post J, Crowell MD. High-resolution manometry in the evaluation of anorectal disorders: a simultaneous comparison with water-perfused manometry. Am J Gastroenterol. 2007;102(4):850-5.
  • Lee YY, Erdogan A, Rao SS. High resolution and high definition anorectal manometry and pressure topography: diagnostic advance or a new kid on the block? Curr Gastroenterol Rep. 2013;15(12):360.
  • Martin D. Physical activity benefits and risks on the gastrointestinal system. South Med J. 2011;104(12):831-7.
  • Ford AC, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014;109:1547-61.
  • Eswaran S, Muir J, Chey WD. Fiber and functional gastrointestinal disorders. Am J Gastroenterol. 2013;108(5):718-27.
  • Bharucha AE, Pemberton JH, Locke GR, 3rd. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144(1):218-38.
  • Ford AC, Talley NJ. Laxatives for chronic constipation in adults. BMJ. 2012;345:e6168.
  • Lee-Robichaud H, Thomas K, Morgan J, Nelson RL. Lactulose versus polyethylene glycol for chronic constipation. Cochrane Database Syst Rev. 2010(7):CD007570.
  • Dupont CA, Campagne A, Constant F. Efficacy and safety of a magnesium sulfate-rich natural mineral water for patients with functional constipation. Clin Gastroenterol Hepatol. 2014;12(8):1280-7.
  • Kamm MA, Mueller-Lissner S, Wald A, Richter E, Swallow R, Gessner U. Oral bisacodyl is effective and well-tolerated in patients with chronic constipation. Clin Gastroenterol Hepatol. 2011;9(7):577-83.
  • Lembo AJ, Schneier HA, Shiff SJ, Kurtz CB, MacDougall JE, Jia XD, et al. Two randomized trials of linaclotide for chronic constipation. N Engl J Med. 2011;365:527-36.
  • Camilleri M. New treatment options for chronic constipation: mechanisms, efficacy and safety. Can J Gastroenterol. 2011;25SupplB: 29B-35B.
  • Camilleri M, Van Outryve MJ, Beyens G, Kerstens R, Robinson P, Vandeplassche L. Clinical trial: the efficacy of open-label prucalopride treatment in patients with chronic constipation - follow-up of patients from the pivotal studies. Aliment Pharmacol Ther. 2010;32(9): 1113-23.
  • Rao SS. Biofeedback therapy for constipation in adults. Best Pract Res Clin Gastroenterol. 2011;25(1):159-66.
  • Maria G, Cadeddu F, Brandara F, Marniga G, Brisinda G. Experience with type a botulinum toxin for treatment of outlet-type constipation. Am J Gastroenterol. 2006;101(11):2570-5.
  • Taghavi SA, Shabani S, Mehramiri A, Eshraghian A, Kazemi SM, Moeini M, et al. Colchicine is effective for short-term treatment of slow transit constipation: a double-blind placebo-controlled clinical trial. Int J Colo-rectal Dis. 2010;25(3):389-94.
  • Nyam DC, Pemberton JH, Ilstrup DM, Rath DM. Long-term results of surgery for chronic constipation. Dis Colon Rectum. 1997;40(3):273-9.
  • Knowles CH, Scott M, Lunniss PJ. Outcome of colectomy for slow transit constipation. Ann Surg. 1999;230(5):627-38.
  • Li F, Fu T, Tong W, Zhang A, Li C, Gao Y, et al. Effect of different surgical options on curative effect, nutrition, and health status of patients with slow transit constipation. Int J Colorectal Dis. 2014;29(12):1551-6.