Prevalence of elimination dysfunction, among primary school age children in Sari

Elimination dysfunction is referred to have various difficulties in urination and defecation, such as urinary frequency, delayed with difficulty in voiding or defecation. The prevalence of elimination dysfunction has been varied in different studies, as 21% of children experience elimination dysfunction during their childhood period. Presently, there are no studies pertaining to this difficulty in our country. Therefore, we carried out a descriptive study in primary schools from the Sari Township, regarding voiding and defecation dysfunction among children, and also we identified the epidemiology of the disease, in order to solve problems by implementing teaching programs and screening methods. This cross-sectional study was done on Primary school age students in the Sari Township, during 2007 through 2008. Considering the prevalence of elimination dysfunction [15-25%], confidence coefficient 95%, SE 10%, and the sample size of 2, 200 were randomly and equally selected from different parts of the township among the two-sex groups. A standard questionnaire including demographic characteristics and 10 questions on voiding status, in addition to 19 questions regarding defecation status was prepared. Questionnaires were distributed to the students by responsible school personnel and then referred to parents for completion. Data was analyzed by SPSS software and descriptive statistics [Frequency, Mean, and Standard Deviation]. Chi Square test [X[2]] and Student T-test were used to compare the Means. P < 0.05 was considered significant. Of 2201 primary school age students, 48.7% were girls. The mean age was 8.96 +/- 1.43 year. Voiding and defecation dysfunction was reported in 38.4% and 29% of the cases respectively. There was no significant relationship between prevalence of voiding dysfunction and other factors such as mean age, sex and level of education; however, there was a significant relationship between elimination dysfunction in other variables such as age, sex, level of education, family history, Soya and fiber diet in-take and environmental stressors. The mean age of children with voiding dysfunction was less than children without this problem. However, the prevalence of familial stress was higher than those involved children. Public Health Education is recommended to teach the different kinds of elimination dysfunction symptoms in urban and rural areas, in addition, to reduce the undesirable complications of the disease due to delay in referrals

Síndrome de mala eliminación / Dysfunctional elimination syndrome

El Síndrome de Mala Eliminación (SME) comprende la alteración en la evacuación a nivel intestinal y urinario, en distintos grados y formas de presentación clínica. Diversos estudios muestran el origen de esta patología en una alteración a nivel de la musculatura del piso pelviano. El objetivo de esta revisión es entregarle al pediatra una visión general de este concepto, usa cada vez más utilizado en la literatura internacional, destacando la importancia de la sospecha clínica, diagnóstico y manejo precoz. Los resultados de estudios internacionales avalan la necesidad del tratamiento conjunto de la afección urinaria y gastrointestinal, para lograr mayor porcentaje de mejoría. El enfoque conjunto de la incontinencia y la constipación, más la amplia gama de situaciones clínicas que cada uno de ellos conlleva, es el objetivo que persigue introducir este nuevo síndrome.

Animus: um desafio diagnóstico e terapêutico / Animus: a diagnosis and therapeutic challenger

O animus tem sido implicado como o principal componente da evacuação obstruída. Além da constipação intestinal, a proctalgia crônica é outra manifestação freqüente deste distúrbio. O diagnóstico envolve medições laboratoriais do esforço evacuatório, sendo a proctografia dinâmica o exame padrão-ouro. O tratamento consiste, na maioria dos casos, de retreinamento com biofeedback (BF), associado a medidas dietoterápicas e uso de laxantes suaves.