Contribuição Da Manometria Anorretal Na Avaliação Da Constipação Intestinal Crônica

Vieira, Eduardo de Paula; Lima, M.B.C; Rosa, R. Di; Azevedo, Lucas Perello de; Machado, Raphael C. S.; Delabio, Ferraz Edna; Neto, João de Aguiar Pupo

doi:10.1016/j.jcol.2017.09.188

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…According to epidemiological studies, about 80% of patients who complain constipation are female. [19][20][21][22] Constipation used to be considered as a reduced bowel frequency. However, it is more complex and subjective, and may be reported as a difficulty in evacuation, sensation of incomplete evacuation, abdominal distention, discomfort and pain.…”

Section: Discussionmentioning

confidence: 99%

Clinical and manometric investigation in constipated Chagasic patients with and without megacolon

Leite

Moreira

Barbosa

et al. 2019

Journal of Coloproctology

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Background Chagasic colopathy is the second most common digestive manifestation, and constipation is the main symptom. The absence of the Rectoanal Inhibitory Reflex plays an important role in constipation and anal manometry is crucial for appropriate evaluation. Purpose Evaluate anal manometry findings (mainly Rectoanal Inhibitory Reflex) in Chagasic patients with chronic constipation, with and without megacolon and correlate these findings with clinical and demographic data. Methods Cross-sectional study of patients with chronic constipation who underwent Chagasic serologic test, barium enema, and anal manometry. The absence of Rectoanal Inhibitory Reflex was evaluated using the mid-P Exact Test. Results 64 Patients were included: 23 Chagasic patients with megacolon/megarectum (G1), 21 Chagasic patients without megacolon/megarectum (G2) and 20 non-Chagasic patients without megacolon/megarectum (G3). Chagasic patients with megacolon had a higher incidence of fecaloma (39%) compared to the other two groups (9.5% and 10% for G2 and G3, respectively, p = 0.03). Rectal capacity on manometry was statically higher for G1 patients. Rectoanal Inhibitory Reflex was absent in 91.3% of patients in G1, 47.29% in G2 and present in all patients in G3. There was a significant difference in the absence of the Rectoanal Inhibitory Reflex when comparing the groups (G1 vs. G2: p = 0.002, G1 vs. G3: p < 0.001, G2 vs. G3: p < 0.001). Conclusion The absence of RAIR confirms the diagnosis of Chagasic colopathy and endorses surgical treatment whenever clinical treatment fails. The presence of the RAIR in patients with positive serology for Chagas disease without megacolon/megarectum might not be due chagasic colopathy and other causes should be considered.

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Section: Discussionmentioning

confidence: 99%

Clinical and manometric investigation in constipated Chagasic patients with and without megacolon

Leite

Moreira

Barbosa

et al. 2019

Journal of Coloproctology

View full text Add to dashboard Cite

show abstract

“…Neste contexto, a elevada incidência está associada à idade, sexo feminino, baixo nível socioeconômico, dieta inadequada, sedentarismo, alterações endócrinas e metabólicas, além de doenças neurológicas, distúrbios psiquiátricos e causas idiopáticas 3,[7][8][9][10][11][12] . A fisiopatologia da CI é complexa e multifatorial 13 , e os sintomas frequentemente encontrados são as fezes ressecadas, poucas evacuações semanais (< 3 vezes), esforço para evacuar, sensação de evacuação incompleta e tempo excessivo para a evacuação 14 . A cronicidade dos sintomas, a falta de orientação terapêutica adequada e o uso abusivo de laxantes podem ter como implicações o surgimento de outras disfunções, como por exemplo, hemorróidas 15 .…”

Section: Introductionunclassified

Prevalência De Constipação Intestinal Em Estudantes Da Área Da Saúde

2015

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Prevalência de constipação intestinal em estudantes da área da saúde Bowel constipation prevalence in health care students ABSTRACTObjective: To estimate the Bowel constipation prevalence in health care students, and to analyze the comparison of methods -the Constipation Assessment Scale and the ROMA III criteria -by means of similarity and specificity in this Bowel constipation sample. Methods: Allied health care undergraduate students answered a protocol containing questions related to health related quality of life, number of evacuations per day, ROMA III criteria for evacuations, auto referred constipation and Constipation Assessment Scale. Results: Bowel constipation prevalence was 63.7% according to ROMA III criteria, 46.6% according to Constipation Assessment Scale and 26.4% according to auto referred Bowel constipation. Psychological risk factors that presented significant association to Bowel constipation were the stress and anxiety. We also found that the ROMA III criteria and Constipation Assessment Scale presented an adequate similarity between methods. Conclusion: This study showed a relevant prevalence of Bowel constipation in students an adequate similarity between diagnosis methods.

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What is the value of proctography for diagnostic of outlet obstruction?

Cesar¹,

Klug²,

Ortíz³

et al. 2011

J. Coloproctol. (Rio J.)

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The diagnosis of constipation is complicated due to the multiplicity and complexity of the causes. Regarding diagnostic tests, proctography is the best choice because it provides information on functions and visualization of abnormalities. Objective: To measure the isolated value of proctography in patients with obstructed defecation. Method: We evaluated 40 constipated patients at the Coloproctology Clinic of Santa Casa de Misericórdia de São Paulo. The test was performed by introducing 120 mL of barium contrast in the rectum and by analyzing the different stages of evacuation. Three x-rays were performed in the lateral position: rest, anal contraction and evacuation. Results: The diagnoses were: rectocele: 2 (5.0%); anismus: 8 (20.0%); perineal descent: 13 (32.5%); sigmoidocele: 6 (15.0%); internal invagination: 10 (25.0%); rectocele + sigmoidocele 9 (22.5%); rectocele + internal invagination 11 (27.5%); rectocele + anismus: 18 (45.0%). Several patients presented multiple disorders. Conclusion: Constipation by obstructed defecation depends on multiple factors and it is important to have an accurate diagnosis. Proctography is essential, but insufficient as a single procedure. The other tests contribute with the diagnosis, therefore, they should be included in the investigation.
O diagnóstico da constipação é difícil pela multiplicidade e complexidade das causas. Dos exames diagnósticos, a proctografia é preferida, fornecendo informações da função e visualização de anormalidades. Objetivo: Medir o valor isolado da proctografia, em pacientes com diagnóstico de defecação obstruída. Método: Avaliamos 40 pacientes com constipação intestinal do Ambulatório de Coloproctologia da Santa Casa de Misericórdia de São Paulo. O exame foi feito introduzindo-se 120 mL de contraste no reto e analisando-se as diferentes fases da evacuação. Foram realizadas três radiografias na posição lateral: repouso, contração anal e evacuação. Resultados: Os diagnósticos foram: retocele: 2 (5,0%); contração paradoxal do puborretal: 8 (20,0%); descida perineal: 13 (32,5%); sigmoidocele: 6 (15,0%); invaginação interna: 10 (25,0%); retocele + sigmoidocele: 9 (22,5%); retocele + invaginação: 11 (27,5%); retocele + contração paradoxal: 18 (45,0%). Vários pacientes apresentaram distúrbios múltiplos. Conclusão: Constipação por defecação obstruída depende de múltiplos fatores e é importante o diagnóstico preciso. A proctografia é essencial, mas insuficiente como procedimento isolado. Os outros exames são importante contribuição para firmar o diagnóstico, devendo ser incluídos na investigação

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Contribuição Da Manometria Anorretal Na Avaliação Da Constipação Intestinal Crônica

Cited by 3 publications

References 24 publications

Clinical and manometric investigation in constipated Chagasic patients with and without megacolon

Clinical and manometric investigation in constipated Chagasic patients with and without megacolon

Prevalência De Constipação Intestinal Em Estudantes Da Área Da Saúde

What is the value of proctography for diagnostic of outlet obstruction?

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