RESUMO
El estreñimiento es un problema común. La mayoría de las personas resolverá el problema por si mismo, sin embargo hay un porcentaje que no lo logran y requieren de ayuda médica. Sigue siendo un reto para el médico seleccionar quienes se beneficiarán de estudios para excluir enfermedad orgánica, de estudios específicos para evaluar el mecanismo fisiopatológico implicado, y cuál es el mejor tratamiento para cada paciente. En este capítulo se revisan los aspectos más relevantes para el manejo de pacientes con estreñimiento funcional.
Constipation is a common problem. Most people solve the problem by itself, but there is a percentage who do not succeed and require medical help. It remains a challenge for the physician to select those who will benefit from studies to exclude organic disease, specific studies to evaluate the physiological mechanism involved, and what is the best treatment for each patient. In this chapter we review the most relevant aspects for the management of patients with functional constipation.
RESUMO
Antecedente La enfermedad por reflujo gastroesofágico (ERGE) es una condición frecuente, con grandes diferencias geográficas en todo el mundo. Uruguay carece de datos epidemiológicos sobre esta enfermedad. Objetivo Estimar la prevalencia de la ERGE en 2 poblaciones adultas de Uruguay, urbana y hospitalaria, mediante el Gastroesophageal reflux disease Questionnaire (GerdQ) e interrogatorio de síntomas típicos. Material y método Se realizó un estudio descriptivo de corte transversal mediante el uso de 2 métodos diagnósticos administrados a 2 niveles: urbano y hospitalario. Uno de ellos fue el cuestionario GerdQ, estandarizado, de respuesta estructurada y el otro consistió en evaluar síntomas característicos de ERGE. Se incluyeron 1.141 personas procedentes de población urbana, con edad promedio de 52 (± 18 años) y 163 pacientes de una policlínica de gastroenterología, con edad promedio de 53 años (± 16 años).Resultados La prevalencia de ERGE en Uruguay utilizando el cuestionario GerdQ fue 4,69%, (IC 95% 2,92-6,46%), mientras que al considerar solo los síntomas típicos ascendió a 14,14% (IC 95% 12,57-15,71). En la muestra hospitalaria la prevalencia fue de 11,66% (IC 95% 6,42-16,89%) y 20,25% (IC 95% 14,01-26,48), respectivamente. Conclusión La prevalencia obtenida en la población urbana de Uruguay con el cuestionario GerdQ en la población sintomática (hospitalaria) fue más del doble respecto de la población general, 11,66 y 4,69%, respectivamente. La evaluación de síntomas, pirosis y/o regurgitación conduce sistemáticamente a un resultado de mayor prevalencia. El consenso en la definición de la ERGE y la herramienta utilizada son claves para interpretar y comparar los estudios epidemiológicos (AU)
Background Gastroesophageal reflux disease (GERD) is a common condition, with wide geographical differences worldwide. There are no epidemiological data on this disease for Uruguay. Objective To estimate the prevalence of GERD in two adult populations in Uruguay (urban and hospital) through the Gastroesophageal reflux disease Questionnaire (GerdQ) questionnaire and evaluation of typical symptoms. Material and method A descriptive, cross-sectional study was carried out through the use of two diagnostic methods administered in two settings: an urban and a hospital setting. The first method consisted of administration of the standardized GerdQ structured questionnaire and the other consisted of evaluating the typical symptoms of GERD. A total of 1141 persons from the urban population, with a mean age of 52 years (± 18 years), and 163 persons from a gastroenterology polyclinic, with a mean age of 53 years (± 16 years), were included. Results The prevalence of GERD in Uruguay was 4.69%, (95% CI 2.92-6.46%) when the GerdQ questionnaire was used, but increased to 14.14% (95% CI 12.57-15.71) when only typical symptoms were considered. In the hospital sample, the prevalence was 11.66% (95% CI 6.42-16.89%) and 20.25% (95% CI 14.01-26.48), respectively. Conclusion The prevalence obtained in the urban population of Uruguay with the GerdQ questionnaire in the symptomatic (hospital) population was more than double that in the general population, 11.66% and 4.69%, respectively. Evaluation of symptoms, pyrosis and/or regurgitation systematically yields a higher prevalence. Consensus on the definition of GERD and on the instrument used for its diagnosis are essential to interpret and compare epidemiological studies (AU)
Assuntos
Humanos , Refluxo Gastroesofágico/epidemiologia , Azia/epidemiologia , Estudos Transversais , Uruguai/epidemiologia , Inquéritos Epidemiológicos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Gastroesophageal reflux disease (GERD) is a common condition, with wide geographical differences worldwide. There are no epidemiological data on this disease for Uruguay. OBJECTIVE: To estimate the prevalence of GERD in two adult populations in Uruguay (urban and hospital) through the Gastroesophageal reflux disease Questionnaire (GerdQ) questionnaire and evaluation of typical symptoms. MATERIAL AND METHOD: A descriptive, cross-sectional study was carried out through the use of two diagnostic methods administered in two settings: an urban and a hospital setting. The first method consisted of administration of the standardized GerdQ structured questionnaire and the other consisted of evaluating the typical symptoms of GERD. A total of 1141 persons from the urban population, with a mean age of 52 years (± 18 years), and 163 persons from a gastroenterology polyclinic, with a mean age of 53 years (± 16 years), were included. RESULTS: The prevalence of GERD in Uruguay was 4.69%, (95% CI 2.92-6.46%) when the GerdQ questionnaire was used, but increased to 14.14% (95% CI 12.57-15.71) when only typical symptoms were considered. In the hospital sample, the prevalence was 11.66% (95% CI 6.42-16.89%) and 20.25% (95% CI 14.01-26.48), respectively. CONCLUSION: The prevalence obtained in the urban population of Uruguay with the GerdQ questionnaire in the symptomatic (hospital) population was more than double that in the general population, 11.66% and 4.69%, respectively. Evaluation of symptoms, pyrosis and/or regurgitation systematically yields a higher prevalence. Consensus on the definition of GERD and on the instrument used for its diagnosis are essential to interpret and compare epidemiological studies.
