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Froehner Junior I, Jorge JMN, Marques CFS, Santos VLCDG, Jukemura J. CONSTIPATION SCORING SYSTEM VALIDATED FOR THE PORTUGUESE LANGUAGE (ÍNDICE DE GRAVIDADE DA CONSTIPAÇÃO INTESTINAL): IS IT RELIABLE IN ASSESSING THE SEVERITY OF INTESTINAL CHRONIC CONSTIPATION IN OUR POPULATION? ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2024; 36:e1785. [PMID: 38511799 PMCID: PMC10949929 DOI: 10.1590/0102-672020230067e1785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/08/2023] [Indexed: 03/22/2024]
Abstract
BACKGROUND There is a lack of valid and specific tools to measure chronic constipation severity in Brazil. AIMS To validate the Constipation Scoring System for Brazilian spoken Portuguese. METHODS Translation, cultural adaptation, and validation itself (reliability and convergent and divergent validation). Translation: definitive version from the original version's translation and evaluation by specialists. Cultural adaptation: score content analysis of the definitive version, as an interview to patients. Interobserver reliability: application by two researchers on the same day. Intraobserver reliability: same researcher at different times, in a 7-day interval. Divergent validation: non-constipated volunteers. Convergent validation: two groups, good response to clinical treatment and refractory to treatment. RESULTS Cultural adaptation: 81 patients, 89% female, with mean age of 55 and seven years of schooling, and overall content validity index was 96.5%. Inter and intraobserver reliability analysis: 60 patients, 86.7% female, mean age of 56 and six years of schooling, and the respective intraclass correlation coefficients were 0.991 and 0.987, p<0.001. Divergent validation: 40 volunteers, 25 male, mean age of 49 years, and the mean global score was 2. Convergent validation of patients with good response to clinical treatment: 47 patients, 39 female, mean age of 60 and six years of schooling, and the pre- and post-treatment scores were 19 and 8, respectively (p<0.001). Convergent validation of refractory to clinical treatment patients: 75 patients, 70 female, mean age of 53 and seven years of schooling, and the global average score was 22. CONCLUSIONS The Constipation Scoring System (Índice de Gravidade da Constipação Intestinal) validated for the Brazilian population is a reliable instrument for measuring the severity of intestinal chronic constipation.
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Affiliation(s)
- Ilario Froehner Junior
- Universidade de São Paulo, Faculty of Medicine, Department of Gastroenterology - São Paulo (SP), Brazil
| | - José Marcio Neves Jorge
- Universidade de São Paulo, Faculty of Medicine, Department of Gastroenterology - São Paulo (SP), Brazil
| | | | | | - José Jukemura
- Universidade de São Paulo, Faculty of Medicine, Department of Gastroenterology - São Paulo (SP), Brazil
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Vu NTH, Quach DT, Miyauchi S, Luu MN, Yoshida M, Nguyen DTN, Yoshino A, Miyaka Y, Okamoto Y, Oka S, Hiyama T. Prevalence and associated factors of chronic constipation among Japanese university students. Front Public Health 2024; 12:1258020. [PMID: 38292906 PMCID: PMC10824902 DOI: 10.3389/fpubh.2024.1258020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
Background Chronic constipation (CC) is one of the most frequently reported gastrointestinal disorders in the general population and a prominent problem among university students. The study aimed to evaluate the prevalence and the associated factors of CC among Japanese university students. Methods This cross-sectional study was conducted among university students at Hiroshima University, Japan. Students answered the web questionnaire when making a web reservation for the health checkup (April 1 to May 31, 2023). The web questionnaire consisted of four sections, including baseline characteristics, lifestyle factors, family history of CC, and three scales to assess depression and eating disorders: the Beck Depression Inventory (BDI), Eating Attitudes Test (EAT)-26 and Bulimic Investigatory Test (BITE). CC was diagnosed using Rome IV criteria. The multivariate logistic regression model was used to determine CC-related factors. Results Out of 10,500 individuals who participated in the annual health checkup, 7,496 participants answered the web questionnaire, of whom 5,386 answered all the survey questions. The mean age of the students was 21.1 ± 4.1 years. The male-to-female ratio was 1:1.17. The prevalence of CC was 13.7%. Factors significantly associated with CC in the multivariate model were first-degree family members with CC [Odd ratio (OR): 2.77, 95% confidence interval (CI): 2.31-3.31], severe depression according to BDI scale (OR: 2.59, 95% CI: 1.96-3.43), female sex (OR: 2.00, 95% CI: 1.69-2.36), and short sleep duration of 6 hours or less per day (OR: 1.28, 95% CI: 1.09-1.50). Lack of physical exercise tended to be associated with CC (OR: 1.19, 95% CI: 1.00-1.40). Conclusions CC is prevalent among Japanese university students. Significant risk factors for CC included the first-degree family history of CC, severe depression, female sex, and short sleep duration. Lack of physical exercise tended to be associated with CC. This may contribute to implementing suitable education health programs, health care professionals, and public health policies to identify individuals at risk for CC to prevent and treat CC effectively.
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Affiliation(s)
- Nhu Thi Hanh Vu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Duc Trong Quach
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Shunsuke Miyauchi
- Health Service Center, Hiroshima University, Higashihiroshima, Japan
| | - Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Mahoko Yoshida
- Health Service Center, Hiroshima University, Higashihiroshima, Japan
| | - Doan Thi Nha Nguyen
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
| | - Atsuo Yoshino
- Health Service Center, Hiroshima University, Higashihiroshima, Japan
| | - Yoshie Miyaka
- Health Service Center, Hiroshima University, Higashihiroshima, Japan
| | - Yuri Okamoto
- Health Service Center, Hiroshima University, Higashihiroshima, Japan
| | - Shiro Oka
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Toru Hiyama
- Health Service Center, Hiroshima University, Higashihiroshima, Japan
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Barberio B, Judge C, Savarino EV, Ford AC. Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol 2021; 6:638-648. [PMID: 34090581 DOI: 10.1016/s2468-1253(21)00111-4] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Functional constipation is a common functional bowel disorder in the community, which has a varying prevalence across cross-sectional surveys. We did a contemporaneous systematic review and meta-analysis of studies using comparable methodology and all iterations of the Rome criteria to estimate the global prevalence of functional constipation. METHODS In this systematic review and meta-analysis, we searched MEDLINE, Embase, and Embase Classic from Jan 1, 1990, to Dec 31, 2020, to identify population-based cross-sectional studies comprising at least 50 participants that reported the prevalence of functional constipation in adults (age 18 years and older) according to Rome I, II, III, or IV criteria. We excluded studies that reported the prevalence of functional constipation in convenience samples. We extracted prevalence estimates of functional constipation from eligible studies, according to the study criteria used to define it. For each study, we extracted data for country; method of data collection; criteria used to define functional constipation; whether the study used the Rome I, II, III, or IV diagnostic questionnaires or approximated these definitions of the condition using another questionnaire; the total number of participants providing complete data; age; the number of participants with the condition; the number of male and female participants; and the number of male and female participants with the condition. We calculated pooled prevalence, odds ratios (OR), and 95% CIs. FINDINGS Of 8174 citations evaluated, 45 studies fulfilled the eligibility criteria, representing 80 separate populations and comprising 275 260 participants. The pooled prevalence of functional constipation was 15·3% (95% CI 8·1-24·4, I2=99·4%) in studies using the Rome I criteria, 11·2% (7·9-14·9; I2=99·6%) in studies that used Rome II criteria, 10·4% (6·5-14·9; I2=99·8%) in those that used Rome III criteria, and 10·1% (8·7-11·6; I2=98·2%) when Rome IV criteria were used. Prevalence of functional constipation was higher in women, irrespective of the Rome criteria used (OR 2·40 [95% CI 2·02-2·86] for Rome I, 1·94 [1·46-2·57] for Rome II, and 2·32 [1·85-2·92] for Rome III; no studies using Rome IV criteria reported prevalence by sex). There was significant heterogeneity between studies in all of our analyses, which persisted even when the same criteria were applied and similar methodologies used. INTERPRETATION Even when uniform symptom-based criteria are used to define the presence of functional constipation, prevalence varies between countries. Thus, environmental, cultural, ethnic, dietary, or genetic factors can influence reporting of symptoms. Future studies should aim to elucidate reasons for this geographical variability. FUNDING None.
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Affiliation(s)
- Brigida Barberio
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, University of Padova-Azienda Ospedaliera di Padova, Padova, Italy
| | - Ciaran Judge
- Department of Gastroenterology, St James's University Hospital, Dublin, Ireland
| | - Edoardo V Savarino
- Department of Surgery, Oncology and Gastroenterology, Gastroenterology Unit, University of Padova-Azienda Ospedaliera di Padova, Padova, Italy
| | - Alexander C Ford
- Leeds Gastroenterology Institute, St James's University Hospital, Leeds, UK; Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
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Silveira EA, Santos ASEADC, Ribeiro JN, Noll M, Dos Santos Rodrigues AP, de Oliveira C. Prevalence of constipation in adults with obesity class II and III and associated factors. BMC Gastroenterol 2021; 21:217. [PMID: 33980157 PMCID: PMC8114515 DOI: 10.1186/s12876-021-01806-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/19/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Constipation and obesity have common risk factors. However, little is known about the occurrence of constipation in individuals with severe obesity and the associated factors. OBJECTIVE To evaluate the prevalence of intestinal constipation and its associated factors in adults with obesity class II and III. METHOD This study analyzed baseline data from a randomized clinical trial with adults aged 18-64 with a Body Mass Index (BMI) ≥ 35 kg/m2, living in the metropolitan region of Goiânia, Brazil. Data were collected using a questionnaire containing sociodemographic, lifestyle, level of obesity, presence of comorbidities, water intake and food consumption variables. The outcome variable was constipation assessed by the Rome III criteria and the Bristol Stool Form Scale. Multiple Poisson regression analysis was used to assess the association between explanatory variables and the outcome. RESULTS Among the 150 participants, the prevalence of constipation was 24.67% (95% CI: 17.69-31.64). After multiple regression analyses constipation was associated with polypharmacy (adjusted PR: 2.99, 95% CI: 1.18-7.57, p = 0.021), younger age group i.e. 18-29 years (adjusted PR: 3.12, 95% CI: 1.21-8.06, p = 0.019) and former smoking (adjusted PR: 3.24, 95% CI: 1.28-9.14, p = 0.014). There was no statistically significant association between constipation and daily consumption of fiber-rich foods, however, the non-consumption of whole grains was borderline significant (adjusted PR: 2.92, 95% CI: 1.00 to 8.49, p = 0.050). CONCLUSION A high prevalence of constipation was found in adults with obesity class II and III. Constipation was significantly associated with the simultaneous use of five or more medications, younger age group and being a former smoker.
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Affiliation(s)
- Erika Aparecida Silveira
- Faculty of Medicine, Postgraduate Program in Health Sciences, Federal University of Goias, Goiania, Brazil.
- Affiliate Academic, Department of Epidemiology and Public Health, University College London, London, UK.
| | | | | | - Matias Noll
- Faculty of Medicine, Postgraduate Program in Health Sciences, Federal University of Goias, Goiania, Brazil
- Federal Institute Goiano, Ceres, Brazil
| | | | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
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Diagnosis and treatment of constipation: a clinical update based on the Rome IV criteria. JOURNAL OF COLOPROCTOLOGY 2021. [DOI: 10.1016/j.jcol.2018.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AbstractThe aim of this study was to evaluate the published professional association guidelines regarding the current diagnosis and treatment of functional intestinal constipation in adults and to compare those guidelines with the authors’ experience to standardize actions that aid clinical reasoning and decision-making for medical professionals. A literature search was conducted in the Medline/PubMed, Scielo, EMBASE and Cochrane online databases using the following terms: chronic constipation, diagnosis, management of chronic constipation, Roma IV and surgical treatment. Conclusively, chronic intestinal constipation is a common condition in adults and occurs most frequently in the elderly and in women. Establishing a precise diagnosis of the physiopathology of functional chronic constipation is complex and requires many functional tests in refractory cases. An understanding of intestinal motility and the defecatory process is critical for the appropriate management of chronic functional intestinal constipation, with surgery reserved for cases in which pharmacologic intervention has failed. The information contained in this review article is subject to the critical evaluation of the medical specialist responsible for determining the action plan to be followed within the context of the conditions and clinical status of each individual patient.
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Dantas AAG, Pereira ARR, de Castro SS, Dantas THDM, Ferreira CWS, Barbosa IR, da Câmara SMA, Dantas DDS. Is Constipation Associated with Worse Functioning in Adult Women? A Cross-Sectional Study. J Multidiscip Healthc 2020; 13:883-889. [PMID: 32982264 PMCID: PMC7490040 DOI: 10.2147/jmdh.s257397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/07/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of this study is to analyze the relationship between intestinal constipation and functioning in adult women living in a municipality in the interior of northeast Brazil. MATERIALS AND METHODS This is a cross-sectional study conducted with 195 adult women in the city of Santa Cruz-RN. Constipation was diagnosed using the Rome III criteria. Functioning was measured through WHODAS 2.0. Social conditions, habits and lifestyle were also investigated. Inferential analysis was performed using the chi-squared test and the Mann-Whitney U-test, and the effect size was determined by eta squared (η2). Multivariate analysis was performed using multiple linear regression to analyze the relationship between the WHODAS total score and constipation, being adjusted by covariates with p≤0.20 in the bivariate. A statistical significance level of p<0.05 was considered. RESULTS Most of the participants in this study were aged 19 to 39 years (69.7%) and had an income of up to 1 minimum monthly salary (79.5%). WHODAS scores showed that women with constipation had more disability in the cognitive (p <0.001), mobility (p <0.002), self-care (p <0.001), and participation (p <0.001) domains, as well as the total score (p <0.001). After multiple linear regression analysis, the total WHODAS score remained associated with constipation (p <0.001), in which this condition increases the score by nine points. CONCLUSION The results of this study show that there is a reduction in functioning associated with the presence of constipation in adult women, mainly affecting the cognition, mobility, self-care and participation domains, in addition to the total score.
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Affiliation(s)
- Amanda Almeida Gomes Dantas
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | | | | | - Thaissa Hamana de Macedo Dantas
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Caroline Wanderley Souto Ferreira
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
- Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Isabelle Ribeiro Barbosa
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
- Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Saionara Maria Aires da Câmara
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
- Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Diego de Sousa Dantas
- Faculdade de Ciências da Saúde do Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
- Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Abstract
Abstract
Introduction Defecation disorders, whether anal incontinence or chronic intestinal constipation, are frequent pelvic floor alterations in the general population and are more common in those with risk factors,i.e., in the elderly, women with an obstetric background, and those with comorbidities, history of pelvic radiotherapy, diabetics, the bedridden, or those with history of orifice surgery, among others.
Objective To analyze the incidence of defecation disorders in geriatric patients treated at the Medical Specialties Outpatient Service (MSOS) of Hospital Santa Marcelina.
Methods Prospective, randomized study that interviewed the same patients in two moments: 1) subjective anamnesis through spontaneous history and 2) objective anamnesis with specific questionnaires to assess anal incontinence and chronic constipation.
Results Between March 2016 and June 2017, 149 patients were analyzed, of whom 114 (76.5%) were female, with a similar mean age between genders; 51.67% had symptoms of anal incontinence and/or chronic constipation. Only 35.5% of patients with complaints of fecal leakage or flatus spontaneously reported them, while 87.1% of constipated patients did so. In the present study, no significant correlation was observed between the mode of delivery (p = 0.106), pregnancy (p = 0.099), and the number of deliveries (p = 0.126) with anal incontinence. In turn, there was no higher incidence of chronic intestinal constipation in females (p = 0.099) and most patients with this complaint had Bristol type 1 or 2 stools.
Conclusion The incidence of defecation disorders in the geriatric population is high and, most notably, anal incontinence is not spontaneously reported by most patients.
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Dantas AAG, Barbosa IR, Castro SSD, Ferreira CWS, Camara SMAD, Dantas DDS. PREVALENCE AND FACTORS ASSOCIATED WITH CONSTIPATION IN PREMENOPAUSAL WOMEN: A COMMUNITY-BASED STUDY. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:188-192. [PMID: 32609161 DOI: 10.1590/s0004-2803.202000000-36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intestinal constipation is characterized by problems related to evacuation, and presents high prevalence in the female gender. This condition has demonstrated negative effects on the development of daily activities, causing damage to the physical and emotional well-being of individuals who are diagnosed with it. Studies that investigate what health impairments intestinal constipation can cause are scarce in the literature. OBJECTIVE This study aimed to verify the prevalence and factors associated with intestinal constipation in premenopausal women living in Northeastern Brazil. METHODS It is a cross-sectional study. This was carried out in the northeast of Brazil. Participated 195 women, adult and middle age. Social conditions, habits and lifestyle, clinical aspects and obstetric history were investigated. Constipation was diagnosed using the Rome III Criteria. Multivariate analysis was conducted using Poisson Regression with robust variance to analyze the relationship between intestinal constipation and independent variables. A statistical significance level of P<0.05 was considered. RESULTS Most of the women were between 25 and 39 years old (49.2%) and had an income of up to one minimum wage (79.5%). The intestinal constipation prevalence was 35.4%. In the final multivariate regression model, hemorrhoid clinical aspects (P=0.01), pain (P=0.001) and a burning sensation (P=0.01) on bowel movement, and sexual dysfunction (P=0.03) remained associated with constipation. CONCLUSION The present study found a significant prevalence of constipation among premenopausal women and clinical factors such as hemorrhoids, pain and a burning sensation, and sexual dysfunction were associated with intestinal constipation.
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Affiliation(s)
- Amanda Almeida Gomes Dantas
- Universidade Federal do Rio Grande do Norte, Faculdade de Ciências da Saúde de Trairi (FACISA), Santa Cruz, RN, Brasil
| | - Isabelle Ribeiro Barbosa
- Universidade Federal do Rio Grande do Norte, Faculdade de Ciências da Saúde de Trairi (FACISA), Santa Cruz, RN, Brasil
| | | | | | | | - Diego de Sousa Dantas
- Universidade Federal do Rio Grande do Norte, Faculdade de Ciências da Saúde de Trairi (FACISA), Santa Cruz, RN, Brasil.,Universidade Federal de Pernambuco, Recife, PE, Brasil
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Teza DCB, Ferreira ÉC, Gomes ML. BOWEL FREQUENCY AND SYMPTOMS OF CONSTIPATION AND ITS RELATION WITH THE LEVEL OF PHYSICAL ACTIVITY IN PATIENTS WITH CHAGAS DISEASE. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:161-166. [PMID: 32609158 DOI: 10.1590/s0004-2803.202000000-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 02/20/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Intestinal constipation (IC) in patients with the digestive form of Chagas disease is one of the main reasons for seeking medical care. Population data indicate that the practice of physical activity improves gastrointestinal motility. OBJECTIVE This study evaluated the bowel frequency and symptoms of constipation and their relationship with the level of physical activity in patients with and without Chagas disease. METHODS Patients (n=120) of both genres, aged between 35 and 84 years, in which 50% (n=60) were in the Chagas group and 50% (n=60) were in the control group, were evaluated regarding the level of IC using the Constipation Assessment Scale (CAS) and regarding the level of physical activity using the International Physical Activity Questionnaire (IPAQ). RESULTS - Patients in the Chagas group classified as active (IPAQ 2) had higher proportion (P=0.0235) of moderate IC with severe abdominal distension (P=0.0159) and decreased evacuation frequency (P=0.0281) than the patients in the control group, considered to be very active (IPAQ 1). The sedentary lifestyle was greater (P=0.0051) in the Chagas group with duration, intensity and frequency of physical activity lower than the control group. The health perception in the Chagas group was regular for 46.7% (P=0.0035) and poor for 8.3% (P=0.0244). CONCLUSION There is a lower risk of developing intestinal constipation in more active individuals, evidencing that the level of physical activity interferes with bowel frequency and symptoms of constipation in patients with and without Chagas disease. The level of physical activity and health perception were worse in the Chagas group, reinforcing the disease stigma, which should be modified by the training of health professionals who routinely attend these patients.
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Affiliation(s)
- Daniela Carolina Barizon Teza
- Universidade Estadual de Maringá, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Maringa, PR, Brasil
| | - Érika Cristina Ferreira
- Universidade Estadual de Maringá, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Maringa, PR, Brasil
| | - Mônica Lúcia Gomes
- Universidade Estadual de Maringá, Departamento de Ciências Básicas da Saúde, Parasitologia, Maringá, PR, Brasil
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Tallyne de Aguiar Silva A, Lima Cavalcanti ID, Ayanny de Lima Fernandes M, Gisele de Oliveira Coimbra C, Manoella de Souza Lima G. Effect of zymomonas mobilis probiotic on cholesterol and its lipoprotein fractions and the intestinal regulation. Clin Nutr 2020; 39:3750-3755. [PMID: 32471645 DOI: 10.1016/j.clnu.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/09/2020] [Accepted: 04/02/2020] [Indexed: 11/28/2022]
Abstract
Zymomonas mobilis have characteristics that classify it as probiotic. Thus, this study aimed to evaluate the effect of regular consumption of fermented broth of this strain on the intestinal function of individuals with changes in intestinal transit. This is a randomized, descriptive and quantitative clinical trial, a sample composed of undergraduate students from a university center in Caruaru. After screening for individuals with constipation according to the inclusion and exclusion criteria, only 13 agreed to participate in the study. They were divided into groups: group 1 received Zymomonas mobilis fermented broth once a day; group 2 also received the fermented broth in the same concentration cells being twice a day; group 3 received cell-free fermented broth once daily; and group 4, placebo, received saline once daily, all groups drank for fifteen days, and laboratory tests were performed to check lipid profile before and after that period. Observed an increase in evacuation days in all groups averaged in media 7.0-10.5 days. Groups 1 and 2 showed an increase in total cholesterol (0.5% and 5.0%, respectively), HDL cholesterol (4.1% and 24.1%), LDL cholesterol (4.9% and 8.4%), VLDL cholesterol (17.9% and 11.2%) and triglycerides (19.1% and 27.9%). In group 3, there was a reduction of total cholesterol (-2.4%), LDL cholesterol (-11.2%), VLDL cholesterol (-15.9%), triglycerides (-27.7%) and increase in HDL cholesterol (25.7%). Thus, the broth fermented with Zymomonas mobilis regulated the intestinal transit, but did not improve the lipid profile, while the without cells broth showed a better lipid profile.
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Affiliation(s)
- Andreza Tallyne de Aguiar Silva
- Lato Sensu Multiprofessional Residence Program in Cancer Attention and Palliative Care, University Center Tabosa of Almeida (ASCES-UNITA), Caruaru, Pernambuco, Brazil.
| | - Iago Dillion Lima Cavalcanti
- Lato Sensu Multiprofessional Residence Program in Cancer Attention and Palliative Care, University Center Tabosa of Almeida (ASCES-UNITA), Caruaru, Pernambuco, Brazil
| | - Maria Ayanny de Lima Fernandes
- Lato Sensu Multiprofessional Residence Program in Cancer Attention and Palliative Care, University Center Tabosa of Almeida (ASCES-UNITA), Caruaru, Pernambuco, Brazil
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De Aquino FDM, Costa CR, De Aguiar DX, Costa NM. Prevalência da constipação intestinal em acadêmicos de medicina de uma instituição particular do estado de Tocantins, Brasil. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i2.868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objetivos: Analisar a prevalência e características da constipação intestinal (CI) em acadêmicos de medicina de uma instituição particular do Estado do Tocantins, Brasil. Métodos: Estudo transversal e quantitativo, com aplicação de questionário a acadêmicos de medicina do 1º, 3º e 6º período. Foi realizada a coleta de dados gerais e específicos, de agosto a setembro de 2018, para a caracterização da CI, seguido de estatística descritiva. Resultados: A maioria dos 142 entrevistados era do 1º semestre do curso (n = 73; 51,4%), tinham até 28 anos (n = 133; 94%) e eram mulheres (n = 90; 63,4%). A maioria fazia suas refeições em casa (n = 106; 74,6%) e 84 (59,1%) realizavam quatro ou mais refeições ao dia. A maioria (n = 54, 38%) fazia uso de folhas verdes e frutas uma a duas vezes por dia. A presença de CI autoreferida ocorreu em 22 acadêmicos (15,5%) enquanto a CI funcional, caracterizada como esforço ao evacuar ou fezes endurecidas, ocorreu em 38 (26,7%). A minoria (n = 27; 19%) referiu frequência evacuatória até três vezes por semana. Além do esforço ao evacuar e fezes endurecidas, o sintoma mais prevalente foi a sensação de evacuação incompleta (n = 32; 22,5%). Conclusão: A constipação intestinal apresenta-se como um quadro pouco frequente entre os acadêmicos do curso de medicina estudado. O esforço evacuatório e fezes endurecidas foram os achados mais prevalentes.
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Abstract
The aims of this study were to estimate the prevalence of constipation and identify associated factors among adults living in an urban area in Londrina, Brazil. This was a secondary analysis of an epidemiological, population-based study on bowel habit performed in 2008 with 2,162 individuals selected through cluster sampling. Interviews were administered using a sociodemographic questionnaire and the adapted and validated Brazilian version of the "Bowel Function in the Community" tool. Variables from the original database were used to determine the prevalence of constipation (according to the Rome Criteria III) and associated factors. The chi-square test and multivariate logistic regression were used for data analysis. The overall prevalence of constipation (14.6%; n = 315) was higher among women than among men (21.9% vs. 5.3%), increased with age among men, and was inversely related to family income. Overall, female gender, low socioeconomic status, history of anal fissure, anorectal surgery, stroke, nervous system disease, fistulae, and hemorrhoids were factors significantly associated with constipation. The variables low social economic status, stroke, anal fissure history, and anorectal surgery were statistically significant in all three tested statistical models.
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Coronel ALC, Silva HTH. [Domestic violence and constipation: an integrative review]. Rev Panam Salud Publica 2017; 41:e19. [PMID: 31391817 PMCID: PMC6660885 DOI: 10.26633/rpsp.2017.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/25/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To search the literature for evidence of a relationship between domestic violence and constipation. METHODS An integrative review was conducted using the six-step approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We examined articles published between 2005 and 2015 investigating the correlation between domestic violence and constipation. The search was performed in September and October of 2015 in PubMed, MEDLINE, Scopus, and Web of Science. The selection of articles was performed in three stages: search, pre-selection, and inclusion. RESULTS Of 177 articles identified, 11 were included in the review. Of these 11 articles, seven were quantitative, three were qualitative, and one was mixed. Four articles focused on children and adolescents, two investigated medical knowledge regarding the relationship between domestic violence and constipation, one reviewed digestive disorders in the elderly, one evaluated the results of biofeedback for the treatment of constipated individuals with or without a history of violence, and one evaluated evacuatory disorders and correlated the result of defecography with history of domestic violence. Finally, two studies were specialist reports. Level of evidence was 1B and recommendation grade A in three studies. All studies detected a relationship between domestic violence and intestinal constipation. CONCLUSION The results of the present review support a correlation between domestic violence and intestinal constipation. The investigation of this relationship is recommended in clinical practice.
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Affiliation(s)
- Ana Lúcia Couto Coronel
- Universidade Federal de Ciências da Saúde de Porto AlegrePrograma de Pós-Graduação em Ensino na SaúdePorto Alegre (RS)BrasilUniversidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-Graduação em Ensino na Saúde, Porto Alegre (RS), Brasil.
| | - Helena Terezinha Hubert Silva
- Universidade Federal de Ciências da Saúde de Porto AlegreDepartamento de Patologia e Medicina Legal e Programa de Pós-Graduação em Ensino na SaúdePorto Alegre (RS)BrasilUniversidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Patologia e Medicina Legal e Programa de Pós-Graduação em Ensino na Saúde, Porto Alegre (RS), Brasil.
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Lim YJ, Rosita J, Chieng JY, Hazizi AS. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students. PLoS One 2016; 11:e0167243. [PMID: 27997551 PMCID: PMC5172545 DOI: 10.1371/journal.pone.0167243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/10/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. METHODS Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. RESULTS The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06-2.06) and age group (odds ratio: 1.34, 95% CI: 1.01-1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08-2.17, P < 0.05). CONCLUSIONS Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among the female respondents. Early detection of symptoms and further intervention studies focusing on treatment recommendation in improving the symptoms are essential.
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Affiliation(s)
- Ying Jye Lim
- Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Jamaluddin Rosita
- Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Jin Yu Chieng
- Department of Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
| | - Abu Saad Hazizi
- Department of Nutrition & Dietetics, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor Darul Ehsan, Malaysia
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Mirghafourvand M, Homayouni Rad A, Mohammad Alizadeh Charandabi S, Fardiazar Z, Shokri K. The Effect of Probiotic Yogurt on Constipation in Pregnant Women: A Randomized Controlled Clinical Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e39870. [PMID: 28203450 PMCID: PMC5294450 DOI: 10.5812/ircmj.39870] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/12/2016] [Accepted: 08/13/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Probiotics can alter the colonic microbiota and might improve bowel function. OBJECTIVES The aim of this study was to evaluate the effect of the consumption of yogurt, enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 (CFU) on the symptoms of constipated pregnant women. MATERIALS AND METHODS This triple-blind randomized controlled trial was conducted on 60 constipated pregnant women who were diagnosed by the ROME III criteria in Tabriz, Iran from December 2014 to July 2015. Participants were randomly put into two groups including the treatment and the control group through block randomization. The treatment group received 300 g of yogurt enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 colony forming units (CFU) (n = 30) while the control group received conventional yogurt (n = 30) for 4 weeks. The defecation frequency, stool consistency, straining during defecation, sensation of anorectal obstruction, sensation of incomplete evacuation and manual manoeuvres to facilitate defecation were primary outcomes while the amount of defecation, stool colure, and quality of life were secondary outcomes. RESULTS The frequency of defecation was increased from 2.1 (0.8) at baseline to 8.3 (4.4) in the probiotic yogurt group vs. 2.3 (0.7) at baseline to 8.1 (4.3) in the conventional yogurt group at the end of 4th week. These results were based on the repeated measure ANOVA test and there was no statistically significant difference between the two groups (mean difference: 0.1; Confidence Interval 95%: -1.4 to 1.7; P = 0.872). Constipation symptoms including straining, anorectal obstruction, manipulation to facilitate defecation, consistency of stool and color of stool were improved significantly (P < 0.05) in both groups. In addition, the amount of defecation was significantly increased in both groups (P < 0.05), while incomplete evacuation was significantly reduced in the treatment group (P = 0.01). There was no statistically significant difference between the groups in the mean scores of physical (P = 0.726) and mental (P = 0.678) aspects of quality of life after the intervention with the adjusting of baseline scores. CONCLUSIONS Consumption of 300 g/day probiotic and conventional yogurt can play a role in improving the symptoms of constipation during pregnancy.
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Affiliation(s)
- Mojgan Mirghafourvand
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Aziz Homayouni Rad
- Department of Food Science and Technology, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | | | - Zahra Fardiazar
- Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran
| | - Kolsoum Shokri
- Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran
- Corresponding Author: Kolsoum Shokri, Students Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR Iran. Tel: +98-4133312679, Fax: +98-4133340634, E-mail:
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Neto IJFC, Maneira ALC, Teixeira NB, Vettorato BD, de Oliveira MC, Menezes TAT, Robles L. There is an agreement between constipation referred and that documented by objective criteria? JOURNAL OF COLOPROCTOLOGY 2016. [DOI: 10.1016/j.jcol.2016.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Abstract
Introduction Chronic constipation is the most common digestive complaint at the doctor's office, with high prevalence in the population. However, many patients – and even those physicians not so familiar with pelvic floor disorders–define and consider constipation based on intestinal functionality and stool consistency. But symptoms of incomplete defecation, digital maneuvers, abdominal discomfort, and straining should not be overlooked.
Objectives To investigate the correlation between constipation referred and documented through objective criteria in patients admitted on a daytime-nursing ward basis at the Hospital Santa Marcelina, São Paulo.
Methodology This is a prospective study of a random sample of patients admitted on a daytime-ward hospitalization basis at Santa Marcelina Hospital to perform minor surgical procedures not related to functional disorders of the gastrointestinal tract in the period from September 2014 to June 2015; the only exclusion criterion was “not agreed to participate in the interview conducted by students of medicine at Santa Marcelina Medical School”.
Results 102 patients were randomly analyzed in the period considered (51% female) with a mean overall age of 48.6 (19–82) years. Constipation has been reported spontaneously by 17.6% of participants and denied by 82.4%. With the implementation of the Cleveland Clinic's criteria for the diagnosis of constipation, the compliance with the referred symptomatology was 88.9%; the same value was found with the use of the Rome III criteria (Kappa = 0.665). In addition, a higher incidence of constipation was observed in female patients (p = 0.002).
Conclusion A higher incidence of constipation was observed in female participants, with no statistical difference with respect to age. Furthermore, a substantial agreement was found between constipation referred and constipation documented through objective criteria.
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Affiliation(s)
- Isaac José Felippe Corrêa Neto
- Hospital Santa Marcelina, Departamento de Cirurgia Geral, Serviço de Coloproctologia, São Paulo, SP, Brazil
- Faculdade de Santa Marcelina, São Paulo, SP, Brazil
- Sociedade Brasileira de Coloproctologia, Brazil
| | | | | | | | | | | | - Laercio Robles
- Hospital Santa Marcelina, Departamento de Cirurgia Geral, Serviço de Coloproctologia, São Paulo, SP, Brazil
- Faculdade de Santa Marcelina, São Paulo, SP, Brazil
- Colégio Brasileiro de Cirurgiões, Brazil
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Klaus JH, Nardin VD, Paludo J, Scherer F, Bosco SMD. The prevalence of and factors associated with constipation in elderly residents of long stay institutions. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2015. [DOI: 10.1590/1809-9823.2015.13175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective : Constipation is a frequent motility disorder and while a common complaint among the overall population, is particularly prevalent among the elderly. The increase of this population group is creating a growing demand for long term care institutions. The present study aims to investigate the prevalence of and factors associated with constipation in elderly residents of long stay care institutions. Method : The study involved 87 individuals. The data collected from each participant included gender, daily intake of water and fiber, physical activity, family history of constipation and nutritional status. The diagnosis of constipation was based on Roma III criteria. Statistical analysis was performed with the SPSS software program (version 18.0) with a level of significance of 5% (p≤0.05). The Student t, Mann-Whitney, Pearson's chi-square or Fischer's exact tests were employed. Results : The sample was predominantly female (80.5%), with a mean age of 79.4(±9.6) years. A 42.52% prevalence of constipation was observed. Among affected individuals, the condition was more frequent among women (89.2%), those aged over 80 years (67.6%), those who did not engage in physical activity (56.8%), those with below the recommended intake of water and fiber, those who had a family history of constipation, and those who were diagnosed with eutrophia (56.3%). Among the factors analyzed, only age (p=0.049) and low fiber intake (p=0.019) were significantly linked to constipation. Conclusion : The results show that constipation is a multifactorial disease that is significantly related to age and low fiber intake.
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Abstract
BACKGROUND Postpartum constipation, with symptoms such as pain or discomfort, straining, and hard stool, is a common condition affecting mothers. Haemorrhoids, pain at the episiotomy site, effects of pregnancy hormones and haematinics used in pregnancy can increase the risk of postpartum constipation. Eating a high-fibre diet and increasing fluid intake is usually encouraged, although laxatives are commonly used in relieving constipation. The effectiveness and safety of available interventions for preventing postpartum constipation needs to be ascertained. OBJECTIVES To evaluate the effectiveness and safety of interventions for preventing postpartum constipation. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2015), Stellenbosch University database, ProQuest Dissertation and Theses database, World Health Organization International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov (30 April 2015) and reference lists of included studies. SELECTION CRITERIA All randomised controlled trials (RCTs) comparing any intervention for preventing postpartum constipation versus another intervention, placebo or no intervention. Interventions could include pharmacological (e.g. laxatives) and non-pharmacological interventions (e.g. acupuncture, educational and behavioural interventions).We included quasi-randomised trials. Cluster-RCTs were eligible for inclusion but none were identified. Studies using a cross-over design were not eligible for inclusion in this review. DATA COLLECTION AND ANALYSIS Two review authors independently screened the results of the search to select potentially relevant studies, extracted data and assessed risk of bias. Results were pooled in a meta-analysis only where there was no substantial statistical heterogeneity. MAIN RESULTS We included five trials (1208 postpartum mothers); four compared a laxative with placebo and one compared a laxative alone versus the same laxative plus a bulking agent in women who underwent surgical repair of third degree perineal tears. Trials were poorly reported and risk of bias was unclear for most domains. Overall, there was a high risk of selection and attrition bias. Laxative versus placeboNone of the four trials included in this comparison assessed any of our pre-specified primary outcomes (pain or straining on defecation, incidence of postpartum constipation or changes in quality of life).All four trials reported time to first bowel movement (not pre-specified in our protocol). In one trial, more women in the laxative group had their first bowel movement less than 24 hours after delivery compared to women in the placebo group (risk ratio (RR) 2.90, 95% confidence interval (CI) 2.24 to 3.75, 471 women). Individual trials also reported inconsistent results for days one, two and three after delivery. Pooled results of two trials showed that fewer women in the laxative group were having their first bowel movement at day four compared with controls (average RR 0.36, 95% CI 0.21 to 0.61, 671 women).Regarding secondary outcomes, no trials reported on stool consistency using the Bristol stool form scale orrelief of abdominal pain/discomfort . One trial reported the number of women having loose or watery stools and there were more women who experienced this in the laxative group compared to the placebo group (RR 26.96, 95% CI 3.81 to 191.03, 106 women). One trial found no clear difference in the number of enemas between groups (RR 0.63, 95% CI 0.38 to 1.05, 244 women). One trial reported more women having more than two bowel movements per day in the laxative compared to the placebo group (RR 26.02, 95% CI 1.59 to 426.73, 106 women). Adverse effects were poorly reported; two trials reported the number of women having abdominal cramps, but their results could not be pooled in a meta-analysis due to substantial statistical heterogeneity. In one trial, more women in the laxative group had abdominal cramps compared to the placebo group (RR 4.23, 95% CI 1.75 to 10.19, 471 women), while the other trial showed no difference between groups (RR 0.25, 95% CI 0.03 to 2.20, 200 women). With regards to adverse effects of the intervention on the baby , one trial found no difference in the incidence of loose stools (RR 0.62, 95% CI 0.16 to 2.41, 281 women) or diarrhoea (RR 2.46, 95% CI 0.23 to 26.82, 281 women) between the two groups. Laxative versus laxative plus bulking agentOnly one trial was included in this comparison and reported on pain or straining on defecation in women who underwent surgical repair of third degree perineal tears; there was no reported difference between groups (median (range) data only). No difference was reported in the incidence of postpartum constipation (data not reported) and the outcome changes in quality of life was not mentioned.Time to first bowel movement was reported as a median (range) with no difference between the two groups. In terms of adverse effects , women in the laxative plus stool-bulking group were reported to be at a greater risk of faecal incontinence during the immediate postpartum period (median (range) data only). However the number of women having any episode of faecal incontinence during first 10 days postpartum was reported with no clear difference between the two groups (14/77 (18.2%) versus 23/70 (32.9%), RR 0.55, 95% CI 0.31 to 0.99, 147 women). The trial did not report on adverse effects of the intervention on the babies.The trial reported none of the following pre-specified secondary outcomes: stool consistency using Bristol stool form scale , use of alternative products , laxative agents , enemas , relief of abdominal pain/discomfort and stool frequency . AUTHORS' CONCLUSIONS We did not identify any trials assessing educational or behavioural interventions. We identified four trials that examined laxatives versus placebo and one that examined laxatives versus laxatives plus stool bulking agents. Results from trials were inconsistent and there is insufficient evidence to make general conclusions about the effectiveness and safety of laxatives.Further rigorous trials are needed to assess the effectiveness and safety of laxatives during the postpartum period for preventing constipation. Trials assessing educational and behavioural interventions and positions that enhance defecation are also needed. Future trials should report on the following important outcomes: pain or straining on defecation; incidence of postpartum constipation, quality of life, time to first bowel movement after delivery, and adverse effects caused by the intervention such as: nausea or vomiting, pain and flatus.
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Affiliation(s)
- Eunice B Turawa
- Stellenbosch UniversityDivision of Community Health, Faculty of Medicine and Health SciencesTygerbergSouth Africa
| | - Alfred Musekiwa
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Faculty of Medicine and Health SciencesCape TownSouth Africa
| | - Anke C Rohwer
- Stellenbosch UniversityCentre for Evidence‐based Health Care, Faculty of Medicine and Health SciencesCape TownSouth Africa
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Schmidt FMQ, Santos VLCDG, Domansky RDC, Barros E, Bandeira MA, Tenório MADM, Jorge JMN. [Prevalence of self-reported constipation in adults from the general population]. Rev Esc Enferm USP 2015; 49:443-52. [PMID: 26107705 DOI: 10.1590/s0080-623420150000300012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/02/2015] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of self-reported constipation and associated factors in the general population of a Brazilian city. METHOD Secondary analysis of an epidemiological study, population-based, cross-sectional study, about bowel habits of Brazilian population. A total of 2,162 individuals were interviewed using two instruments: sociodemographic data and the adapted and validated Brazilian version of the "Bowel Function in the Community" tool. RESULTS There was a prevalence of 25.2% for the self-reported constipation, 37.2% among women and 10.2% among men. Stroke and old age were associated with constipation in the three statistical models used. CONCLUSION The prevalence found showed to be similar to the findings in the literature, although some associated factors obtained here have never been investigated.
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Affiliation(s)
| | | | | | - Elaine Barros
- Servidor Público Estadual Hospital - HSPE, Sao Paulo, SP, Brazil
| | | | | | - José Marcio Neves Jorge
- School of Medicine, Departament of Gastroenterology, University of Sao Paulo, Sao Paulo, SP, Brazil
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Rao SSC, Yu S, Fedewa A. Systematic review: dietary fibre and FODMAP-restricted diet in the management of constipation and irritable bowel syndrome. Aliment Pharmacol Ther 2015; 41:1256-70. [PMID: 25903636 DOI: 10.1111/apt.13167] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/03/2015] [Accepted: 02/28/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Dietary fibre supplements have been advocated for the management of chronic constipation (CC) and irritable bowel syndrome (IBS). Recently, a fermentable oligosaccharide, disaccharide, monosaccharide and polyol (FODMAP) restricted diet has been recommended for IBS. AIM To systematically examine recent evidence for dietary interventions with fibre in CC and IBS and FODMAP-restricted diet in IBS, and provide recommendations. METHODS We searched PUBMED, MEDLINE, OVID and COCHRANE databases from 2004 to 2014. Published studies in adults with CC and IBS and constipation-predominant IBS (IBS-C) that compared fibre with placebo/alternative and FODMAP-restricted diet with alternative were included. RESULTS Of 550 potentially eligible clinical trials on fibre, 11 studies were found and of 23 potentially eligible studies on FODMAPs, six were found. A meta-analysis was not performed due to heterogeneity and methodological quality. Fibre was beneficial in 5/7 studies in CC and 3/3 studies in IBS-C. FODMAP-restricted diet improved overall IBS symptoms in 4/4 and IBS-C symptoms in 1/3 studies and three studies did not meet inclusion criteria. There were significant disparities in subject selection, interventions and outcome assessments in both fibre and FODMAPs studies. CONCLUSIONS Fibre supplementation is beneficial in mild to moderate CC and IBS-C, although larger, more rigorous and long-term RCTs are needed (Fair evidence-Level II, Grade B). Although the FODMAP-restricted diet may be effective in short-term management of selected patients with IBS (Fair evidence-Level II, Grade C) and IBS-C (Poor evidence-Level III, Grade C), more rigorous trials are needed to establish long-term efficacy and safety, particularly on colonic health and microbiome.
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Affiliation(s)
- S S C Rao
- Section of Gastroenterology/Hepatology, Department of Internal Medicine, Georgia Regents University, Augusta, GA, USA
| | - S Yu
- Section of Gastroenterology/Hepatology, Department of Internal Medicine, Georgia Regents University, Augusta, GA, USA
| | - A Fedewa
- Food and Nutrition Department, Georgia Regents University, Augusta, GA, USA
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Prevalence of constipation in the general adult population: an integrative review. J Wound Ostomy Continence Nurs 2015; 41:70-6; quiz E1-2. [PMID: 24378694 DOI: 10.1097/01.won.0000438019.21229.b7] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Constipation affects multiple aspects of a person's health, including health-related quality of life. It is one of the most frequently reported functional gastrointestinal disorders. The purpose of this integrative review of the literature was to identify research findings pertaining to the prevalence of constipation and factors are associated with constipation in the general population. Electronic databases were searched for articles published between 2005 and 2011. All retrieved studies were evaluated with respect to quality according to the guidelines for critical appraisal of health research literature on prevalence and incidence. Eleven studies were retrieved; they reveal a prevalence of constipation that varied from 2.6% to 26.9%. The most frequently cited associated factors were female gender and advanced age, which were cited in 11 and 7 of the studies, respectively. Prevalence rates reported by the selected studies were heterogeneous. This may be partially attributed to variability in methods used to measure prevalence, including differences in criteria for constipation.
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Favretto DC, Pontin B, Moreira TR. Effect of the consumption of a cheese enriched with probiotic organisms (Bifidobacterium lactis bi-07) in improving symptoms of constipation. ARQUIVOS DE GASTROENTEROLOGIA 2014; 50:196-201. [PMID: 24322191 DOI: 10.1590/s0004-28032013000200035] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 05/15/2013] [Indexed: 12/27/2022]
Abstract
CONTEXT Constipation is a very common symptom in the general population. One way of non-pharmacological treatment of constipation is through the addition of probiotics to food. OBJECTIVES The aim of this study was to evaluate de effect of the consumption of a fresh cheese, enriched with Bifidobacterium lactis Bi-07 on the symptoms of constipated women. METHODS A randomized controlled trial, carried out in the Basic Health Units of Guaporé's City - RS/Brazil, between January and May 2012, with 30 constipated women. The patients were randomized into two groups whom received, for 30 days, 30 g of fresh cheese enriched with Bifidobacterium lactis Bi-07 (n = 15) or regular fresh cheese (n = 15). Constipation symptoms were evaluated according to ROMA III Consensus, before and after the nutritional intervention. Also, data of clinical and anthropometric characteristics of the individuals were collected. Accepted level of significance 5% (P≤0,05). RESULTS The medium age of the studied population was 37,5±14,4 years in the intervention group and 40,8±12,8 years in the control group. After 30 days we observed that the ingestion of fresh cheese enriched with Bifidobacterium lactis Bi-07 promoted benefic effects on the symptoms of strength to evacuate. CONCLUSION The consumption of 30g/day of a fresh cheese enriched with Bifidobacterium lactis Bi-07 has beneficial effects on constipation symptoms.
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