Guía de práctica clínica del síndrome del intestino irritable con estreñimiento y estreñimiento funcional en adultostratamiento. (Parte 2 de 2)

  1. F. Mearín 2
  2. C. Ciriza 3
  3. M. Mínguez 4
  4. E. Rey 5
  5. J.J. Mascort 6
  6. E. Peña 7
  7. P. Cañones 8
  8. J. Júdez 1
  1. 1 SEPD, España
  2. 2 Centro Médico Teknon, Barcelona, España
  3. 3 Hospital Universitario Doce de Octubre, Madrid, España
  4. 4 Hospital Clínico Universitario, Universitat de Valencia, Valencia, España
  5. 5 Hospital Clínico San Carlos de Madrid
    info

    Hospital Clínico San Carlos de Madrid

    Madrid, España

    ROR https://ror.org/04d0ybj29

  6. 6 Sociedad Española de Medicina de Familia y Comunitaria (semFYC), España
  7. 7 Sociedad Española de Médicos de Atención Primaria (SEMERGEN), España
  8. 8 Sociedad Española de Médicos Generales y de Familia (SEMG), España
Revue:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Année de publication: 2017

Número: 2

Pages: 123-140

Type: Article

DOI: 10.1016/J.SEMERG.2017.01.001 DIALNET GOOGLE SCHOLAR

D'autres publications dans: Semergen: revista española de medicina de familia

Résumé

In this Clinical practice guide we examine the diagnostic and therapeutic management of adult patients with constipation and abdominal discomfort, at the confluence of the spectrum of irritable bowel syndrome and functional constipation. Both fall within the framework of functional intestinal disorders and have major personal, health and social impact, altering the quality of life of the patients affected. The former is a subtype of irritable bowel syndrome in which constipation and altered bowel habit predominate, often along with recurring abdominal pain, bloating and abdominal distension. Constipation is characterised by infrequent or hard-to-pass bowel movements, often accompanied by straining during defecation or the sensation of incomplete evacuation. There is no underlying organic cause in the majority of cases; it being considered a functional bowel disorder. There are many clinical and pathophysiological similarities between the two conditions, the constipation responds in a similar way to commonly used drugs, the fundamental difference being the presence or absence of pain, but not in an “all or nothing” way. The severity of these disorders depends not only on the intensity of the intestinal symptoms but also on other biopsychosocial factors: association of gastrointestinal and extraintestinal symptoms, degree of involvement, forms of perception and behaviour. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical practice guide adapts to the Rome IV criteria published at the end of May 2016. The first part (96, 97, 98) examined the conceptual and pathophysiological aspects, alarm criteria, diagnostic test and referral criteria between Primary Care and Gastroenterology. This second part reviews all the available treatment alternatives (exercise, fluid ingestion, diet with soluble fibre-rich foods, fibre supplements, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antdepressants, psychological treatment, acupuncture, enemas, sacral root neurostimulation and surgery), and practical recommendations are made for each.