Guía de práctica clínica: síndrome del intestino irritable con estreñimiento y estreñimiento funcional en adultos: concepto, diagnóstico y continuidad asistencial. (Parte 1 de 2)

Abstract

In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them.

A Novel EphA2 Inhibitor Exerts Beneficial Effects in PI-IBS in Vivo and in Vitro Models via Nrf2 and NF-κB Signaling Pathways

“…Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders ( Oświȩcimska et al, 2017 ). It is characterized by the presence of recurrent or chronic abdominal pain or discomfort and bloating ( Mearin et al, 2016 ). Three and thirty-five percentage patients with IBS develop PI-IBS after acute gastrointestinal infection ( Sundin et al, 2015 ).…”

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

“…Para acceder al apartado de Coordinación entre niveles asistenciales (pregunta 35 y tabla 7 de la Parte 1), ver las publicaciones correspondientes96, 97, 98.…”

Eph/ephrin signalling serves a bidirectional role in lipopolysaccharide‑induced intestinal injury

“…Irritable bowel syndrome (IBS) is one of the most prevalent functional gastrointestinal disorders ( 1 ). It is characterised by the presence of recurrent or chronic abdominal pain or discomfort and bloating ( 2 ); 3 and 35% patients with IBS develop post-infectious IBS (PI-IBS) after acute gastrointestinal infection ( 3 ). Although it is not a lethal disorder, PI-IBS jeopardises the quality of life and remains a substantial burden on the health care system.…”