Management of chronic constipation.

Clayden, Graham

doi:10.1136/adc.67.3.340

Cited by 115 publications

(73 citation statements)

References 9 publications

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“…Multiple factors are probably involved in the genesis of constipation, such as genetic factors, intestinal motility disorders, fecal retention behavior and dietary habits (2,3). Clayden (4) reported that approximately half of his patients with chronic constipation presented anorexia, possibly due to a cycle of poor intake, stool retention and poor appe-P.G.L. Speridião et al…”

Section: Introductionmentioning

confidence: 99%

Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation

Speridião

Tahan

Fagundes-Neto

et al. 2003

Braz J Med Biol Res

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The present prospective study was carried out to determine dietary fiber and energy intake and nutritional status of children during the treatment of chronic constipation. Twenty-five patients aged 2 to 12 years with chronic constipation were submitted to clinical evaluation, assessment of dietary patterns, and anthropometry before and after 45 and 90 days of treatment. The treatment of chronic constipation included rectal disimpaction, ingestion of mineral oil and diet therapy. The standardized diet prescribed consisted of regular food without a fiber supplement and met the nutrient requirements according to the recommended daily allowance. The fiber content was 9.0 to 11.9 g for patients aged less than 6 years and 12.0 to 18.0 g for patients older than 6 years. Sixteen patients completed the 90-day follow-up and all presented clinical improvement. The anthropometric variables did not change, except midarm circumference and triceps skinfold thickness which were significantly increased. Statistically significant increases were also found in percent calorie intake adequacy in terms of recommended daily allowance (55.5 to 76.5% on day 45 and to 68.5% on day 90; P = 0.047). Percent adequacy of minimum recommended daily intake of dietary fiber (age + 5 g) increased during treatment (from 46.8 to 52.8% on day 45 and to 56.3% on day 90; P = 0.009). Food and dietary fiber intake and triceps skinfold thickness increased during follow-up. We conclude that the therapeutic program provided a good clinical outcome.

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Section: Introductionmentioning

confidence: 99%

Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation

Speridião

Tahan

Fagundes-Neto

et al. 2003

Braz J Med Biol Res

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“…A anorexia ou diminuição do apetite pode ocorrer e atuar como um fator de agravo e perpetuação da constipação 38,39 . Náuseas, cefaléia, flatulência, indisposição seriam secundários ao aspecto obstrutivo ou doloroso da síndrome.…”

Section: Apresentação Clínicaunclassified

“…O programa terapêutico deve constar fundamentalmente de quatro itens: educação, desimpactação, recondicionamento do hábito intestinal normal e prevenção da reimpactação 11,12,16,18,22,34,38,[41][42][43][44] . Assim, tradicionalmente são incluídas no tratamento as seguintes etapas: orientação geral, esvaziamento do fecaloma, tratamento de manutenção e recondicionamento esfincteriano.…”

Section: Tabela 2 -Causas De Constipação Intestinal Crônica Em Pediatriaunclassified

“…As propostas terapêuticas apresentadas acima são concordantes com as condutas de vários autores do Brasil e do exterior 11,12,16,18,22,34,38,[41][42][43][44] , embora com menos ênfase na fibra alimentar em algumas publicações. Por sua vez, é interessante mencionar que, em 1999, foram publicadas duas propostas de abordagem da constipação em Pediatria com base nas evidências publicadas na literatura, mostrando que nem todas as condutas preconizadas foram alvo de validação por estudos controlados e baseiam-se fundamentalmente na opinião de autoridades respeitadas no assunto 16,44 .…”

Section: Tabela 2 -Causas De Constipação Intestinal Crônica Em Pediatriaunclassified

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Constipation

Maffei¹,

Morais²

2000

J Pediatr (Rio J)

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Objective: An up-to-date review concerning the importance, pathophysiology, clinical presentation, and treatment of chronic constipation in Pediatrics.Methods: Bibliographic review of Medline database and articles published by the authors.Results: Constipation is a common disorder in childhood. The pathophysiology of constipation involves the interaction of several factors: low dietary fiber diet, early weaning, painful bowel movement, fecal retentive behavior, disturbance of intestinal motility and genetic predisposition.The clinical presentation of children with constipation is variable. Several patients present onset of constipation during the first year of life, but the medical treatment is initiated only after a long period. Some patients are recognized from complications like soiling, abdominal pain and urinary abnormalities.Treatment should be adapted to each patient and includes general orientation, complete colonic cleanout, maintenance treatment and a behavioral program to regulate bowel habits.Despite the fact that most children present functional chronic constipation, underlying systemic and intestinal illness must be considered. Specialized evaluation and diagnostic techniques should be indicated according to the individual patient characteristics and when the clinical outcome is not satisfactory.Conclusions: The long term control of chronic constipation depends on the acquisition of dietary habits which provides an adequate intake of dietary fiber. It is possible that a fiber-rich diet is not only important to constipation control but may also reduce the risk of diet-related chronic diseases during adulthood.J. pediatr. (Rio J.). 2000; 76 (Supl.2): S147-S156: constipation, chronic constipation, dietary fiber. ResumoObjetivo: Revisar os conhecimentos atuais sobre impacto, fisiopatologia, apresentação clínica e tratamento da constipação crônica em Pediatria.Métodos: Foram utilizados revisão bibliográfica eletrônica na base de dados do Medline-Bireme, artigos recentes de revisão e publicações prévias dos autores.Resultados: A constipação crônica na infância apresenta elevada prevalência. A fisiopatologia envolve a interação de múltiplos fatores: dieta pobre em fibras, desmame precoce, episódios de evacuação dolorosa, comportamento de retenção fecal, distúrbio da motilidade intestinal e predisposição genética.A apresentação clínica é muito variável. Muitos casos têm início no primeiro ano de vida; no entanto, a procura por assistência médica específica, com freqüência, ocorre após muito tempo. Parcela dos casos são reconhecidos a partir das complicações. As principais complicações são escape fecal, dor abdominal, anorexia e alterações urinárias.O tratamento deve ser individualizado e envolve os procedimentos: orientação geral, esvaziamento do fecaloma, tratamento de manutenção e recondicionamento esfincteriano.Apesar da maioria das vezes a constipação crônica ser de origem funcional, é necessária muita atenção para as entidades que constituem seu diagnóstico diferencial. Avaliação especializada...

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“…[1][2][3][4][5][6][7] Some studies have also shown that insufficient dietary fiber consumption is associated with an increased risk of constipation in children. [8][9] Notwithstanding, systematic literature reviews published in recent years point out that much of the conduct recommended for constipation treatment is based on the opinion of specialists and is not founded on evidence from adequately planned clinical trials.…”

Section: Introductionmentioning

confidence: 99%

Efeito da fibra do polissacarídeo de soja no peso e na umidade das fezes de ratos em fase de crescimento

Freitas¹,

Motta²,

Amâncio³

et al. 2004

J. Pediatr. (Rio J.)

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Objective: To compare the effect of soy polysaccharide on fecal weight and humidity in growing rats in relation to cellulose and a soy formula without dietary fiber.Methods: Twelve, 21-day-old, Wistar male rats, were distributed into three groups and fed AIN-93G ration with varying amounts of dietary fiber: Polysaccharide Group, 5% fiber in the form of soy polysaccharide; Soy Formula Group, 5% soy formula without fiber; and Cellulose Group, 5% fiber in cellulose form. Feces were collected for three 72-hour periods beginning on days 7, 17 and 27. They were weighed while humid and then dried at 105 o C until a constant weight. The humidity was calculated using the formula [(humid fecal weight -dry fecal weight)/humid fecal weight] X 100.

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Management of chronic constipation.

Cited by 115 publications

References 9 publications

Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation

Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation

Constipation

Efeito da fibra do polissacarídeo de soja no peso e na umidade das fezes de ratos em fase de crescimento

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