RESUMO
Abstract Background Irritable bowel syndrome (IBS) is a common gastrointestinal disorder; celiac disease is an autoimmune enteropathy that can mimic any functional gastrointestinal disorder. The aim of this study is to estimate the prevalence of celiac disease antibodies (anti Tissue Transglutaminase-tTG) in patients with irritable bowel syndrome. Patients and methods This cross sectional study was conducted on 70 patients with irritable bowel syndrome fulfilling Rome III criteria who visited Azadi Teaching Hospital in Duhok city-Iraq. Patients were classified according to irritable bowel syndrome subtypes into: Diarrhoea Predominant (D-IBS), Constipation Predominant (C-IBS) and Mixed (M-IBS). IgA and IgG anti tTG were used to screen patients for celiac disease. Results A total number of 70 patients (44 females and 26 males) were included; their mean age was 33 years (SD ± 7.64). Five patients (7.1%) were found to have positive both IgA and IgG anti tTG. Three of them have had D-IBS and the other two had C-IBS. No one of the M-IBS patients tested positive. Conclusion The prevalence of anti tTG antibodies in irritable bowel syndrome is high. Patients with D-IBS should be screened for celiac disease.
Resumo Introdução A síndrome do intestino irritável (SII) é um distúrbio gastrointestinal comum; a doença celíaca é uma enteropatia autoimune que pode imitar qualquer distúrbio gastrointestinal funcional. O objetivo deste estudo foi estimar a prevalência de anticorpos contra a doença celíaca (antitransglutaminase tecidual - tTG) em pacientes com SII. Pacientes e Métodos Este estudo transversal foi conduzido em 70 pacientes com síndrome do intestino irritável que atendiam aos critérios de Roma III e se apresentaram ao Hospital de Ensino Azadi na cidade de Duhok, no Iraque. Os pacientes foram classificados de acordo com os subtipos de síndrome do intestino irritável em: predominantemente diarreia (D-SII), predominantemente constipação (C-SII) e mista (M-SII). IgA e IgG antitTG foram usados para rastrear pacientes com doença celíaca. Resultados Um total de 70 pacientes (44 mulheres e 26 homens) foram incluídos; a idade média foi de 33 anos (DP ± 7,64). Cinco pacientes (7,1%) apresentaram IgA e IgG antitTG positivos. Três deles tinham D-SII e os outros dois tinham C-SII. Nenhum dos pacientes com M-SII apresentou teste positivo. Conclusão A prevalência de anticorpos antitTG na SII é alta. A presença de doença celíaca deve ser avaliada em pacientes com D-SII.
Assuntos
Humanos , Masculino , Feminino , Doença Celíaca , Doença Celíaca/imunologia , Síndrome do Intestino Irritável , Anticorpos/imunologia , Imunoglobulina A , Imunoglobulina G , IraqueRESUMO
AIM: Our aim was to perform a population-based study using Rome III criteria to describe the prevalence of functional gastrointestinal disorders (FGIDs) in infants in three countries in South America. METHODS: We conducted a multicountry, cross-sectional study to investigate the epidemiology of functional gastrointestinal disorders in children aged 0-12 months of age, using the Rome III criteria, in Colombia, Panama and Nicaragua. These patients presented for well-child visits in primary care clinics in the three countries between May 2015 and October 2016. A Spanish version of the Questionnaire on Paediatric Gastrointestinal Symptoms for Infants and Toddlers was used for the data collection. RESULTS: We included questionnaires completed by 351 parents, and they reported at least one FGID in 141 (40%) infants. The majority were male (56%), with a median age of seven months. Colic and functional dyschezia were the most commonly diagnosed disorders in the whole cohort, at 23% and 15%, respectively. The risk of developing FGIDs was not affected by the marital status of the mother, number of siblings, birth order and history of diarrhoea. CONCLUSION: Functional gastrointestinal disorders were common in infants from the South American countries of Colombia, Panama and Nicaragua, particularly colic and functional dyschezia.
Assuntos
Cólica/epidemiologia , Constipação Intestinal/epidemiologia , Gastroenteropatias/epidemiologia , Cólica/diagnóstico , Constipação Intestinal/diagnóstico , Estudos Transversais , Feminino , Gastroenteropatias/diagnóstico , Humanos , Lactente , Recém-Nascido , Masculino , Prevalência , América do Sul/epidemiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To perform a population-based study with Rome III criteria to describe the prevalence of functional gastrointestinal disorders (FGIDs) in children in Colombia. STUDY DESIGN: We conducted a multicity cross-sectional study to investigate the epidemiology of FGIDs in children 0-48 months of age using the Rome III criteria in Colombia. Children with organic medical diseases were excluded. Parents provided demographic information and completed the Spanish version of the Questionnaire on Pediatric Gastrointestinal Symptoms for Infants & Toddlers. RESULTS: Parents of 1231 subjects completed the questionnaires; 48 children were excluded due to presence of organic diseases and being older than 48 months of age. Four hundred eighty children (40.5%) were diagnosed with at least 1 FGID according to the Rome III diagnostic criteria (49% female, median 12 months). Functional constipation was the most commonly diagnosed disorder in infants (up to 12 months of age) and children of ages 13-48 months (16.1% and 26.8%, respectively). Analysis revealed that the prevalence of FGID was significantly greater in children who were the only child in the family (P = .003), children who were first-born (P = .007), and children with divorced or separated parents. (P = .001). CONCLUSIONS: FGIDs are common in children younger than 4 years of age. Functional constipation and infant colic were the most common FGIDs in infants (up to 12 months of age), and functional constipation and rumination were the most common FGIDs in children 13-48 months of age.
Assuntos
Gastroenteropatias/epidemiologia , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , PrevalênciaRESUMO
The sphincter of Oddi dysfunction is a little known entity that typically occurs in post-cholecystectomy patients with abdominal pain with biliary or pancreatic characteristics. It represents an important cause of idiopathic recurrent acute pancreatitis. Most of the patients referred for sphincter of Oddi dysfunction study have another disease which explain the symptoms, so a careful history and appropriate physical examination often can identify the true source of the pain. The most used grading score is the Milwaukee classification, based on clinical, laboratory, imaging and cholangiographic findings. In the last decade, new and more applicable criteria have been developed, such as Rome III criteria, which do not require functional tests considered complex and not available in non-specialized centers. The sphincter of Oddimanometry is considered the gold standard for the diagnosis of this entity, allowing for the determination of which patients will benefit from endoscopic therapy (sphincterotomy). There are some noninvasive diagnostic tests that have failed to show strong correlation to displace the sphincter of Oddi. The treatment of this condition is mainly based on endoscopic sphincterotomy, with variable success rates depending on the type of dysfunction. This article presents a review of the most important aspects related to the sphincter of Oddi and its relationship with idiopathic recurrent pancreatitis.
La disfunción del esfínter de Oddi es una entidad poco conocida, que típicamente se presenta en pacientes post-colecistectomía con dolor abdominal de tipo biliar o pancreático. Representa unaimportante causa de pancreatitis aguda recurrente idiopática. La mayoría de los pacientes derivados para estudio de disfunción del esfínter de Oddi corresponden a otra causa o enfermedad que explica los síntomas, por lo que una cuidadosa historia clínica y un adecuado examen físico, a menudo permiten identificar el verdadero origen del cuadro doloroso. La clasificación más utilizada es la de Milwaukee basada en parámetros clínicos, de laboratorio, imagenológicos y colangiográficos. En la última década, se han elaborado criterios de mayor aplicabilidad clínica como los criterios de Roma III, que no requieren de test funcionales considerados complejos y poco disponibles en centros no especializados. La manometría del esfínter de Oddi es considerado el gold standard en el diagnóstico de esta entidad, permitiendo además, establecer quiénes se beneficiarán con la terapia endoscópica (esfinterotomía). Se han desarrollado una serie de otros métodos diagnósticos no invasivos, que no han logrado demostrar una correlación suficientemente sólida para desplazar a la manometría. El tratamiento de esta condición se basa principalmente en la esfinterotomía endoscópica, con una tasa de éxito variable dependiendo del tipo de disfunción. En el presente artículo se revisarán los aspectos más importantes relacionados con la disfunción del esfínter de Oddi y su relación con pancreatitis recurrente idiopática.
Assuntos
Humanos , Disfunção do Esfíncter da Ampola Hepatopancreática/classificação , Disfunção do Esfíncter da Ampola Hepatopancreática/diagnóstico , Disfunção do Esfíncter da Ampola Hepatopancreática/terapia , Bloqueadores dos Canais de Cálcio/uso terapêutico , Colangiografia , Colecistectomia/efeitos adversos , Diagnóstico Diferencial , Disfunção do Esfíncter da Ampola Hepatopancreática/complicações , Dor Abdominal/etiologia , Doença Aguda , Esfinterotomia Endoscópica , Manometria , Nifedipino/uso terapêutico , Pancreatite/complicações , Colangiopancreatografia Retrógrada Endoscópica , Índice de Gravidade de DoençaRESUMO
El síndrome de intestino irritable (SII) es una entidad clínica crónica, recurrente y común, de difícil diagnóstico, siendo la base diagnóstica la evaluación sintomática. Se ha descrito el estrés emocional como un factor desencadenante de los síntomas que la identifican, pudiéndose presentar con una alta prevalencia en la población joven y laboralmente activa. Objetivos: Determinar la prevalencia del SII, según los Criterios de Roma III, en una población de médicos de tres centros hospitalarios de Maracay. Mayo 2008 y evidenciar la relación del estrés laboral con esta patología. Métodos: A una muestra de 83 médicos especialistas de consultas, aparentemente sanos, del HCM, ASODIAM y HS, escogidos al azar, se les aplicó una encuesta-cuestionario, previo consentimiento verbal individual, interrogando los criterios de Roma III y la Escala de Maslach para medir el estrés laboral. Resultados: Según Roma III la prevalencia del SII en médicos especialistas fue de 37,3% (77,5% femeninos y 22,5% masculinos), de los cuales el 67,7% presentaron estrés laboral. Conclusión: Según el diagnóstico por criterios de Roma III existe una alta prevalencia de SII en la población de médicos especialistas, donde se describe al estrés como posible factor desencadenante de hechos fisiopatológicos que provocan la sintomatología de este síndrome en el grupo estudiado.
Irritable bowel syndrome (IBS) is a clinical chronic entity, recurrent and common; the diagnosis is based on symptomatic diagnostic evaluation. Emotional stress has been described as a trigger for the symptoms; it can be presented with a high prevalence in young population and labor force. Objectives: To determine the prevalence of IBS according to Rome III Criteria in a population of three doctors of hospitals in Maracay, May 2008 and to demonstrate the relationship of work stress with this condition. Methods: A sample of 83 specialists for consultations, apparently healthy of the HCM, and ASODIAM HS, chosen randomly, were interviewed with a questionnaire survey, previous individual verbal consent, using the Rome III Criteria and the Scale of Maslach to measure work stress. Results: According to the Rome III Criteria, the prevalence of IBS in medical specialists was 37.3% (77.5% female and 22.5% male), of which 67.7% had work-related stress. Conclusion: Accordingwith the Rome III Criteria there is a high prevalence of IBS in the physiciansÊ population, which describes stress as a possible trigger for pathophysiological events that cause the symptoms of this syndrome in this study.