Manejo de la constipación crónica del adulto: Actualización: [revisión] / Constipation in adults: An update: [review]

Constipation affects 2 percent to 27 percent of individuals. It is associated to irritable bowel syndrome in 59 percent of cases, to a pelvic floor dysfunction in 29 percent and to a low transit time in 13 percent. During assessment of patients with constipation the effects of medications and chronic diseases must be discarded and the ideal is to determine which type of functional disorder it present. An algorithm for the management of chronic idiopathic constipation, that includes a recommendation to increase fiber and liquid intake as an initial approach and an orientation to the use of different laxatives, is presented. The usefulness of biofeedback in patients with pelvic floor dysfunction and without organic cause of constipation, is also discussed.

Prevalencia de marcadores serológicos ANCA y ASCA en una población con colitis ulcerosa / Presence of antineutrophil cytoplasmic antibodies (ANCA) and anti Saccharomyces cerevisiae antibodies (ASCA) among patients with ulcerative colitis

Background: The diagnosis of inflammatory bowel disease is supported by clinical findings and complementary tests. The presence of specific serological markers could be helpful in the characterization of this condition. Aim: To assess the prevalence of ANCA and ASCA in a group of patients with ulcerative colitis (UC) and its association with clinical features. Material and Methods: Sixty four patients with UC in remission (age range 16-72 years, 33 males) were studied. In a venous blood sample ANCA were measured by indirect immunofluorescence and ASCA by enzyme immune assays for IgG and IgA. Results: Forty four percent of patients were positive for ANCA, 9 percent for ASCA and 6 percent for both markers. There was a significant correlation between the presence of ANCA and duration of the UC (<5 years 50 percent, 5-10 years 42.9 percent, 15 years 30 percent) and the number of crises (one crises 31 percent, 2-5 crises 51.9 percent and >5 crises 87.5). The proportion of colectomized patients with positive ANCA was higher (57.1 percent). Conclusions: The prevalence of ANCA in the studied population is similar to the published data. The presence of ANCA was significantly higher in UC patients with shorter evolution, higher number of crises and in those with a history of colectomy. There was a low prevalence of ASCA positive patients.