El consumo de dos kiwis diarios podría mejorar el hábito intestinal en personas con estreñimiento crónico / Daily consumption of two kiwifruits could improve bowel habits in people with chronic constipation

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)

Prevalence and predictors of changes in bowel habits after laparoscopic cholecystectomy / Prevalência e preditores de alterações do hábito intestinal pós-colecistectomia videolaparoscópica

ABSTRACT Background: The incidence of cholecystolithiasis is approximately 15% of the population. It is believed that between 30-40% of cholecystectomy patients have symptoms after surgery, being changes in bowel habits the most common among them. Aim: 1) Defining the prevalence, and 2) identifying predictors of changes in bowel habits after laparoscopic cholecystectomy. Methods: This is a retrospective cross-sectional study with an initial sample of 150 patients diagnosed with cholecystolithiasis operated between July and September 2014. Patients were submitted to a questionnaire about the presence of gastrointestinal symptoms and changes in stools consistency before and after the surgical procedure. They were divided into two groups (with or without changes in bowel habits) being combined with the following variables: high blood pressure, body mass index, hypothyroidism, adherence to postoperative dietary orientations, previous abdominal and bariatric surgery. Results: The prevalence of changes in bowel habits in the study population was 35.1%. The association between it and gastrointestinal symptoms was demonstrated to be statistically significant (‰2=7.981; p=0.005), and people who did not have gastrointestinal symptoms had 2.34 times the odds of not presenting changes in bowel habits. None of the other investigated factors had shown to be a predictor of risk for post-cholecystectomy changes in bowel habits. Conclusion: 1) There was a high prevalence of changes in bowel habits, and 2) there was association between changes in bowel habits and the presence of gastrointestinal symptoms.

RESUMO Racional: A incidência da colecistopatia calculosa é de aproximadamente 15% da população brasileira. Acredita-se que entre 30-40% dos pacientes colecistectomizados apresentem sintomas pós-operatório, sendo a alteração do hábito intestinal o mais comum. Objetivo: 1) Determinar a prevalência, e 2) identificar preditores de mudanças do hábito intestinal pós-colecistectomia videolaparoscópica. Métodos: Estudo transversal retrospectivo com amostra inicial de 150 pacientes diagnosticados com colecistopatia calculosa, operados entre julho e setembro de 2014. Os pacientes foram submetidos a um questionário sobre a presença de sintomas gastrointestinais após a operação, e a alterações do aspecto das fezes antes e depois do procedimento. A amostra foi dividida em dois grupos (com ou sem mudanças do hábito intestinal) sendo realizadas associações com as seguintes variáveis: hipertensão arterial, IMC, hipotireoidismo, seguimento de dieta no pós-operatório, operação abdominal prévia e operação bariátrica. Resultados: A prevalência de mudanças do hábito intestinal na população estudada foi de 35,1%. A associação entre elas e sintomas gastrointestinais demonstrou-se estatisticamente significativa (‰2=7,981; p=0,005), sendo que as pessoas que não apresentavam os sintomas tinham 2,34 vezes mais chances de não apresentarem mudanças do hábito intestinal. Nenhum dos demais fatores investigados demonstrou ser preditor de risco para mudanças do hábito intestinal pós-colecistectomia. Conclusões: 1) Observou-se alta prevalência de mudanças do hábito intestinal, e 2) houve associação entre mudança do hábito intestinal e a presença de sintomas gastrointestinais.

Avaliação do efeito da ingestão de simbiótico sobre a função intestinal de idosos frequentadores de Universidade Aberta à Terceira Idade, com repercussão em seu bem-estar e em sua qualidade de vida / The effect of the symbiotic ingestion on the intestinal function of the elderly that goes to the University Opened to the Third Aged, with repercussions on their health and their quality of life / Efecto de la ingesta simbiótico en función intestinal fiesteros Universidad ancianos Abierta de la Tercera Edad, con repercusiones en su bienestar y calidad de vida

O objetivo deste estudo foi avaliar o efeito de ingestão de simbiótico sobre a função intestinal de idosos. Participaram 50 idosos de ambos os sexos, divididos em grupo suplemento e placebo, que consumiu simbiótico ou maltodextrina, respectivamente. No grupo que consumiu simbiótico, 84% não apresentou constipação no período pós-intervenção, assim como 76% indicou fezes de consistência normal e ausência de diarreia. Mais estudos são necessários, a fim de avaliar a eficácia de suplemento simbiótico em seres humanos, e verificar sua repercussão no bem-estar e qualidade de vida.

The aim of this study was to evaluate the symbiotic intake effect on intestinal function among the elderly. Participated 50 elderly of both sexes divided into supplement and placebo groups that consumed symbiotic or maltodextrin, respectively. In the group that consumed symbiotic 84% showed no constipation post intervention period, and 76% showed normal stool consistency and absence of diarrhea. Further studies are needed to evaluate the efficacy of symbiotic supplement in humans, and to assess its impact on the welfare and quality of life.

El objetivo de este estudio fue evaluar el efecto de la ingesta simbiótico en función intestinal entre los ancianos. Participado 50 ancianos de ambos los sexos divididos en grupos de suplementos y placebo que consumieron simbiótica o maltodextrina, respectivamente. En el grupo que consumió simbionte, el 84% no mostró periodo posterior a la intervención en frío, y el 76% indicó consistencia normal de las heces y sin diarrea. Se necesitan más estudios para evaluar la eficacia de los suplementos simbiótica en los seres humanos, y comprobar su impacto en el bienestar y calidad de vida.

Evaluación del hábito intestinal en una población de personal hospitalario / Evaluation of bowel habits in a population of hospital staff

Introducción: La función evacuatoria y sus alteraciones constituyen un motivo de consulta muy frecuente. En Venezuela no disponemos de información para definir cuál es el patrón intestinal normal de nuestra población, ni de la frecuencia con que se presentan dichas alteraciones.Objetivo: Evaluar el hábito intestinal en una población de personal hospitalario, entre 18 a 70 años, del Hospital “Dr. Domingo Luciani” entre abril - septiembre del 2008.Método: Es un estudio descriptivo y transversal en el que participaron 507 trabajadores del hospital, a los cuales se les practicó una encuesta personalizada.Resultados: Participaron 380 (75 %) mujeres y 127 (25 %) hombres con una edad 39,2 ±10 años. El 51,1% son universitarios. Menos de la mitad consumen medicamentos o sufren de enfermedades. La mayoría no fuma e ingiere menos de 2 litros de agua/día. El 73,4 % evacúa diariamente, una vez/día y en la mañana, con heces tipo 3. 12 (2,36 %) presentan constipación según ROMA III, edad 39 años, femenino, la mayoría son TSU y enfermeras (p=0,03) e ingieren menos de 2 litros de agua/día, consumen algunas veces frutas y cereales y muy poco realizan ejercicios. Los síntomas predominantes fueron: dispepsia, dolor y distensión abdominal, dolor al evacuar y sensación de evacuación incompleta. Todos evacuan heces tipo 1 y el 41,66 % empleo laxantes. El 50 % manifestó algún grado de alteración de su calidad de vida.Conclusiones: El hábito intestinal de nuestra población se caracterizó por frecuencia evacuatoria diaria, una vez/día; heces tipo 3 y 4, sin sensación de evacuación incompleta, dolor o esfuerzo al evacuar.

Introduction: Bowel function and related disorders are common consulting problems. Because in Venezuela we lack of adequate information to define both bowel normal habit and the frequency of its alterations in our population we decided to perform this study. Objective: To assess bowel function of the “Dr. Domingo Luciani” hospital staff between April and September of 2008.Method: In a descriptive and transversal study, we apply a personalized survey to all the hospital staff who participated.Results: 507 hospital staff members were studied. 380 females (75 %) /127 males (25 %). The average age was 39,2 ±10 years. The 51,1% have an universitary degree, and less than half used medications or suffer diseases. Most of them were no smokers and drink less than 2 liters of water per day. The 73,4 % of the subjects passed a stool on a daily basis, in the morning with feces type 3. 12 patients (2,36 %) had constipation according to Roma III criteria. In those subjects predominant symptoms were: dyspepsia, abdominal pain and bloating, pain during evacuation and incomplete evacuation sensation. All had a type I stool pattern and the 41,66 % used laxatives regularly. The 50 % exhibit some degree of quality of life impairment. Average age in this group was 39 years, female sex, nurses and Higher University Technicians (p=0, 03). They drink less than 2 liters of water/day, sometimes consume fruits and cereals and do very little exercise

Hábito intestinal en adolescentes servicio de gastroenterología Dr. “Alí Rivas” hospital Jesús Yerena de lídice mayo-julio 2006

Los factores de riesgo que conllevan a una mayor incidencia de constipación o estreñimiento son: edad, estilo de vida sedentario, dieta de alto contenido en grasas y azúcar con bajo contenido de fibra. Objetivo: estudiar los patrones del hábito intestinal de una población de adolescentes del oeste de la ciudad de Caracas. Metodología: se realizó un estudio descriptivo de corte transversal, en alumnos adolescentes con edades comprendidas entre 11 y 18 años, de dos colegios privados, de clase media. Resultados: 36,88% sexo masculino y 63,12% femenino. El 71,78% manifestó tener hábito intestinal diario, ínter diario con 20,05%. En la escala de Bristol el 40,84% fue tipo I, 14,6% tipo II, 15,35% tipo III y 29,1% otras combinaciones de la escala. El 58,42% tuvo esfuerzo evacuatorio frecuente y 32,43% algunas veces. 25% tomaba la cantidad igual o mayor a 8 vasos diarios de agua. Discusión: La incidencia de estreñimiento fue de 23,02%, podría estar relacionada con la tendencia al consumo de harinas, refrescos, dulces y al consumo frecuente semanal de comida chatarra. El consumo de frutas diario es de 50% y la gran mayoría no tienen una ingesta adecuada de agua.

The risk factors for constipation are: progressive age, lack of physical activity, a high fat and carbohydrate diet with low amount of fiber. Objective: to describe the normal intestinal patterns of a teenage population in the west side of Caracas, Venezuela. Methods: descriptive transversal cut study in teen age students with ages ranging from 11 to 18 years of age in two private schools. Results: 36, 88% male and 63, 12% females In the Bristol scale, 40, 84% had type I, 14, 6% type II, 15, 35% type III and 29, 1% had a combination of types. 58,42% had frequent evacuatory effort, and 32, 43% sometimes. 25% drank 8 or more glasses of water per day. Discussion: the incidence of constipation was 23, 02%, it could be related to the consumption of processed flour, soft drinks, sweets, and frequent weekly junk food consumption. The daily consumption of fruit was 50% and the majority had inadequate water consumption.