Navegando por Palavras-chave "Constipation"

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    Associação entre violência, constipação intestinal funcional e síndrome do intestino irritável em adolescentes
    (Universidade Federal de São Paulo (UNIFESP), 2020-06-18) Almeida, Camila Nunes Thomaz de [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; http://lattes.cnpq.br/5056114729141952; Universidade Federal de São Paulo
    Objective: To evaluate the association between general, physical, psychological, sexual violence and neglect with the occurrence of functional constipation and irritable bowel syndrome in adolescents. Methodology: Observational study with cross-sectional design conducted with adolescents from public schools in the municipality of Osasco, metropolitan region of São Paulo. A self-administered questionnaire validated for Brazilian Portuguese (ICAST-C: Child Abuse Screening Tools - Children’s version) was used to research the different types of violence. The characterization of functional constipation and irritable bowel syndrome was performed using the Rome IV criteria for adolescents. Parents or legal guardians completed the questionnaire for socioeconomic assessment. Results: 265 students aged 11 to 17 years, 157 female, were evaluated. Functional constipation and irritable bowel syndrome were characterized in 74 (27.9%) of the 265 adolescents studied. General violence was characterized in 82.6%, psychological violence in 93.2%, physical violence in 91.3%, sexual violence in 12.1% and negligence in 53.6%. The multiple logistic regression analysis showed an association (p <0.05) between functional constipation and irritable bowel syndrome with exposure to general violence (OR = 2.77), psychological violence (OR = 2.95), physical violence ( OR = 2.17) and negligence (2.31). There was no association with sexual violence. Conclusion: In the present study, functional constipation and irritable bowel syndrome were associated with general, psychological, physical violence and neglect in adolescent students from public schools. No association was found with sexual violence. It is important, in the future, to conduct studies that investigate the causal relationship between different types of violence and functional gastrointestinal disorders.
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    Avaliação do hábito intestinal e do tratamento da constipação de pacientes com tumores pediátricos em uso de morfina
    (Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Marmo, Michela Cynthia da Rocha [UNIFESP]; Caran, Eliana Maria Monteiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: Evaluate bowel habit in cancer patients using morphine. Analyze the effectiveness of a therapeutic program in controlling constipation secondary to opioid. Method: case study series, non-randomized, prospective. Patients admitted in the study were bearers of cancer, aged over four years, and using morphine for pain control. After 24 hours from the beginning of the use of morphine, patients were given lactulose and in refractory cases, bisacodyl. Evaluation of bowel habit was achieved through a structured questionnaire. When necessary, fecal desimpaction was performed by via anal or oral. Results: 22 patients were admitted to the study, aged between five and 15 years (average 16.7 years). 27% (6/22) patients had constipation before admission in the study. In the first week of use of morphine and lactulose, 40% (9/22) patients had constipation. In the second and third weeks, constipation occurred in 38.8% (7/18) and 16% (2/12), respectively. The therapeutic protocol adopted was able to control the constipation in 57% (11/22) of cases. Conclusions: constipation has been frequent in patients who have used morphine, 40%, 38.8% and 16% respectively in the first, second and third weeks despite the prophylactic treatment with laxatives. However, the protocol with specific attention to constipation can increase adherence to laxatives and minimize the complications of constipation, such as the appearing of fecaloma. Controlled studies are needed with largest number of cases for the development of effective therapeutic strategies, such multi-professional approach, which reduce the suffering of cancer patients who need to use morphine.
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    Características clínicas de pacientes pediátricos com constipação crônica de acordo com o grupo etário
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2007-12-01) Medeiros, Lilian Cristiane Da Silva [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Tahan, Soraia [UNIFESP]; Fukushima, Érika; Motta, Maria Eugênia Farias Almeida; Fagundes-neto, Ulysses [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Pernambuco Departamento Materno-Infantil
    BACKGROUND: There was no study evaluating clinical characteristics of constipation according pediatric age groups. AIM: To evaluate the clinical characteristics of patients with chronic constipation according to age group. METHODS: This retrospective study evaluated the demographic data and clinical characteristics of pediatric patients with chronic constipation who had been admitted to an outpatient clinic between May 1995 and December 2000. Data was analyzed according to the followings age groups: infants, pre-school, school age and adolescent. RESULTS: Five hundred and sixty one patients were included in the study. The percentage of patients according to age groups were: infants (19.1%), pre-school (42.9%), school age (26.9%), and adolescents (11.0%). There was no statistical gender difference among the four age groups. Less than three bowel movements per week were observed more frequently in pre-school (65.8%) and school age (59.6%) than in infants (52.4%) and adolescents (43.1%). Fecal escape (soiling) was found in 75.6% of the pre-school patients aged more than 48 months, in 68.2% of the school age and in 76.7% of the adolescents. Soiling was more frequent in boys (80.7%) than in girls (50.0%) only in school age children. Retentive posture (67.6%, 40.7%, 27.2%), fear for defecation (70.2%, 44.2%, 29.7%) and abdominal pain (80.8%, 69.6%, 73.6%) were observed, respectively, more frequently in pre-school than in school age and adolescents. CONCLUSION: There were differences in clinical characteristics according to age group. However, prolonged duration of constipation and an elevated number of complications were observed in all age groups, especially fecal soiling and abdominal pain.
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    Comparison between perfusion and balloon techniques for performing anorectal manometry in children with intestinal constipation
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2008-10-01) Marques, Geraldo Magela Nogueira [UNIFESP]; Martins, Jose Luiz [UNIFESP]; Nobre, Vânia Dolores Rodrigues Perdigão [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    INTRODUCTION: Two anorectal manometry techniques have commonly been utilized: the perfusion technique and the balloon technique. PURPOSE: To compare both techniques in children with intestinal constipation who had not undergone surgical treatment for its correction. METHODS: Thirty-nine children aged between four and fourteen years underwent anorectal manometry using both techniques at random. Resting pressure, pressure response to voluntary contraction, coughing and perianal stimulation, maximum pressure on the anal canal pressure curve, and presence of rectosphincteric reflex were registered and submitted to statistics. Vectorgraphy of the sphincter muscle complex was obtained by perfusion technique. RESULTS: The statistical comparison between the techniques revealed statistically significant differences in resting pressure (p=0.041), pressure response to voluntary contraction (p=0.026) and maximum pressure within the pressure curve (p=0.010). The rectosphincteric reflex was demonstrated in 21 patients by both techniques. CONCLUSIONS: The perfusion technique presented greater sensitivity in the following parameters: resting pressure, pressure response to voluntary contraction and maximum pressure within the pressure curve. The methods studied are equivalent regarding the measurement of pressure responses to coughing and perianal stimulation and the investigation of rectosphincteric reflex.
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    Constipação e sua relação com toxicidade urêmica em pacientes submetidos à diálise peritoneal
    (Universidade Federal de São Paulo (UNIFESP), 2020-05-28) Pereira, Natalia Barros Ferreira [UNIFESP]; Valle, Lilian Cuppari [UNIFESP]; Ramos, Christiane Ishikawa [UNIFESP]; http://lattes.cnpq.br/9995799269309055; http://lattes.cnpq.br/3552074553183694; http://lattes.cnpq.br/9763912183160394; Universidade Federal de São Paulo
    Introdução: Tem sido sugerido que a doença renal crônica (DRC) induz modificações não desejáveis no ambiente gastrintestinal, levando ao acúmulo de toxinas urêmicas e aumento de permeabilidade intestinal. A constipação, sintoma gastrintestinal frequente em pacientes submetidos à terapia dialítica, parece desempenhar um papel adicional à toxicidade urêmica induzida pela DRC. Objetivo: O objetivo primário deste estudo foi investigar a associação entre constipação e toxinas urêmicas derivadas do intestino e, os secundários, a associação entre constipação, marcadores de permeabilidade intestinal e inflamação em pacientes submetidos a diálise peritoneal (DP). Metodologia: Trata-se de um estudo de corte transversal que incluiu 30 pacientes constipados e 28 não constipados, de acordo com o critério de Roma IV, em programa crônico de diálise peritoneal automatizada da Fundação Oswaldo Ramos – Hospital do Rim, com idade entre 18 e 80 anos. O hábito intestinal também foi avaliado pela Escala de Bristol, e os pacientes classificados em BSS<3 (caracterizado por fezes endurecidas e menor frequência de evacuação) ou BSS≥3 (representando um hábito intestinal mais regular). As concentrações séricas totais e livres de p-cresil sulfato (PCS), indoxil sulfato (IS) e ácido indol-3-acético (IAA) foram determinadas por cromatografia líquida de alta performance (HPLC) Os marcadores séricos de permeabilidade intestinal analisados foram lipopolissacarídeo (LPS), Zonulina, ambos por ensaio ELISA e D(-)-lactato (método colorimétrico). Os marcadores inflamatórios foram proteína C reativa (PCR; método de alta sensibilidade), fator de necrose tumoral alfa (TNF-α; ELISA) e interleucinas (IL-6 e IL-10; ELISA). A ingestão alimentar foi avaliada pelo registro alimentar de três dias. A avaliação global subjetiva (AGS-7) foi empregada para avaliação do estado nutricional e o número de passos registrados por meio do pedômetro. Resultados: Foram incluídos 58 pacientes em DP, 50% (n=29/58) do sexo masculino, com idade média de 52,5±15 anos, 32% (n=18/58) apresentavam diabetes mellitus e tempo em diálise de 14 [6,0-36,5] meses (mediana; interquartil). Não foram observadas diferenças entre os grupos constipado e não constipado em relação às características demográficas, clínicas, dietéticas, nutricionais. Pacientes constipados exibiram tendência a níveis mais elevados de PCS total (216,7 [124,5- 286,7] mmol/L vs 131,1[88.2-216,7] mmol/L; p=0,07) e PCS livre (4,0 [1,6-9,5] mmol/L; vs 2,2 [1,0-5,2] mmol/L; p=0.06). Não houve diferença no IS e IAA entre os grupos. Pacientes constipados apresentaram maior PCR (0,3 [0,2-1,1] mg/dL; vs 0,2 [0,1-0,4] mg/dL; p=0,03) e menor razão de IL-6: IL-10 (0,2 [0,1-0,4]; vs 0,3 [0,2-1,0]; p=0,04) e uma tendência para níveis mais altos de TNF-α (70,8 [45,8-91,6] pg/mL vs 58,7 [40.6-67.8] pg/mL; p=0,08). Não houve diferença nos marcadores de permeabilidade intestinal entre os grupos. Pacientes classificados no BSS<3 (n=11/52, 19%), em comparação àqueles no BSS≥3 exibiram valores maiores de PCS livre (p<0,01), PCS total (p<0,01), IAA total (p=0,04), IL-10 (p=0,01); menor IL-6: IL-10 (p=0,03) e D(-)-lactato (p=0,01). Conclusão: A constipação, caracterizada principalmente por tempo de trânsito intestinal lento, parece estar envolvida no acúmulo de toxinas urêmicas, principalmente PCS, em pacientes em diálise peritoneal.
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    Constipação em lactentes: influência do tipo de aleitamento e da ingestão de fibra alimentar
    (Sociedade Brasileira de Pediatria, 2002-01-01) Aguirre, Andrea Nogueira de Campos [UNIFESP]; Vítolo, Márcia Regina [UNIFESP]; Puccini, Rosana Fiorini [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To study the relationship between breast-feeding, dietary fiber intake and constipation in infants. Methods: The study population consisted of 275 infants consecutively enrolled in two Primary Care Clinic in the city of Embu, in the Great São Paulo. The feeding pattern were classified in predominantly breast-feeding, partially breast and cow s milk feeding and artificial feeding. Constipation was defined by the elimination of hard stool associated with one of the following: painful or difficult defecation, hard or round cracked stools and less than three defecations a week. False constipation was defined by the elimination of soft stools without pain or difficulty but with less than three defecations a week. Results: Constipation was found in 25.1% (69/275). False constipation was found only in the first semester of life in 5.1% of 159 infants. The prevalence of constipation was higher between 6 and 24 months (38.8%, 45/116) than in the first semester of life (15.1%, p=0.000). A model of logistic regression demonstrated that infants under artificial feeding were 4.53 times more liable to develop constipation than infants who were predominantly breastfed. The daily dietary fiber intake (g/day) was similar (p=0.57) among the constipated (median=9.0 g; 25th and 75th percentiles: 6.9-13.1g) and non-constipated (median = 8.8 g; 25th and 75th percentiles: 6.1-12.9 g). Conclusions: Dietary fiber intake was similar in constipated and non-constipated infants. Breast-feeding serves as a protection factor against the development of constipation in the first semester of life.
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    Constipação intestinal em terapia intensiva
    (Associação de Medicina Intensiva Brasileira - AMIB, 2009-08-01) Azevedo, Rodrigo Palácio De [UNIFESP]; Freitas, Flavio Geraldo Rezende [UNIFESP]; Ferreira, Elaine Maria [UNIFESP]; Machado, Flávia Ribeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Constipation is a common complication identified among critically ill patients. Its incidence is highly variable due to lack of definition of such patients. Besides the already known consequences of constipation, in recent years it was observed that this complication may also be related to worse prognosis of critically ill patients. This review endeavors to describe the main available scientific evidence showing that constipation is a prognostic marker and a clinical representation of intestinal dysfunction, in addition to eventually interfering in the prognosis with treatment. Ogilvie syndrome, a major cause of morbidity and mortality in intensive care units was also reviewed. Considering the above cases it was concluded that more attention to this disorder is required in intensive care units as well as development of protocols for diagnosis and management of critically ill patients.
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    Constipação intestinal, impactação fecal e tempo de trânsito colônico em crianças e adolescentes com fibrose cística
    (Universidade Federal de São Paulo (UNIFESP), 2018-03-27) Sillos, Marcela Duarte de [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; http://lattes.cnpq.br/5056114729141952; http://lattes.cnpq.br/5762310344732665; Universidade Federal de São Paulo (UNIFESP)
    Objetivos: 1) Avaliar a prevalência de constipação intestinal e impactação fecal em crianças e adolescentes com fibrose cística; 2) Comparar o tempo de trânsito colônico total e segmentar de pacientes com fibrose cística com e sem constipação intestinal e com e sem impactação fecal. Métodos: Estudo transversal que incluiu crianças e adolescentes com fibrose cística atendidos em ambulatório de referência. Constipação intestinal foi diagnosticada segundo critério da European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). Impactação fecal foi avaliada através da interpretação de radiografia de abdome de acordo com o escore de Barr. O tempo de trânsito colônico foi calculado com o emprego demarcadores radiopacos. Resultados: Constipação intestinal foi encontrada em 44,1% das crianças e adolescentes com fibrose cística, predominando no sexo feminino (p=0,007). Constatouse alta prevalência de impactação fecal (57,1%) que ocorreu em pacientes com e sem constipação intestinal (p=0,445). Pacientes com constipação intestinal apresentaram maior tempo de trânsito colônico total (p=0,028) e no cólon direito (p=0,012). Dismotilidade do tipo estase de cólon direito foi observada em 13,3% dos pacientes constipação intestinal. O tempo de trânsito colônico foi semelhante nos pacientes com e sem impactação fecal. Conclusões: Constipação intestinal foi diagnosticada em quase metade dos pacientes pediátricos com fibrose cística. Impactação fecal, presente na maioria dos pacientes, não se associou com constipação intestinal. Pacientes com fibrose cística e constipação intestinal apresentaram maior tempo de trânsito colônico total e no cólon direito, enquanto que pacientes com e sem impactação fecal apresentaram tempos de trânsito colônico semelhantes.
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    Consumo de fibra alimentar e de macronutrientes por crianças com constipação crônica funcional
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2003-09-01) Gomes, Rosane C.; Maranhão, Hélcio S.; Pedrosa, Lúcia De Fátima C.; Morais, Mauro Batista de [UNIFESP]; Universidade Federal do Rio Grande do Norte Centro de Ciências da Saúde Departamento de Pediatria; Universidade Federal do Rio Grande do Norte Centro de Ciências da Saúde Departamento de Nutrição; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: The aim of this case-control study was to evaluate the intake of fiber alimentary and macronutrients in constipated children. METHODS: Fifty-four children (aged 2-12 yr) with diagnosis of chronic functional constipation were investigated at the Pediatric Hospital, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil. They were age and sex matched with 50 patients without constipation. A standard questionnaire was applied to both groups and a 3 day dietary record was analyzed by computer software. RESULTS: The mean age at onset of symptoms was 29,0 ± 26,1 months. There was not sex predominance and no difference about nutritional condition between the groups. Constipated children ate less fiber, proteins, lipids, carbohydrates and less caloric and protein adequated percentuals. The proportion of children who ate less dietary fiber than recommended (age + 5 g /day) was greater in the constipated group (83,3%) than in controls (66,6%); odds ratio 2,6. CONCLUSION: Constipated children ate less fiber and macronutrients than children without constipation. Intake of dietary fiber below the minimum recommendation is a risk factor for chronic functional constipation in children.
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    Consumo de líquidos, osmolalidade urinária e constipação intestinal funcional em crianças e adolescentes
    (Universidade Federal de São Paulo (UNIFESP), 2015-11-24) Boilesen, Sabine Nunes [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; http://lattes.cnpq.br/5056114729141952; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the consumption of water and the hydration status of pediatric patients with functional constipation. Methodology: controlled cross-sectional study in which children and adolescents were analyzed with and without functional constipation according to the Rome III criteria. The evaluation of the state of hydration was performed by analysis of urinary osmolality. The intake assessment of water and food was made with the 24-hour survey of employment. Results: We evaluated 36 patients with functional constipation and 93 children with normal bowel habit (control group). Patients with constipation, 76.6% were male. There were no differences in weight, height, height for age and arm muscle circumference. The constipated group had lower body mass index (BMI) and BMI for age compared to controls. The median of the total water consumption was lower in the group with constipation (1649.8 mL) than in the control group (2177.8 mL; p <0.001). The low intake of total water, liquid water and water in food were associated factors of functional constipation, with odds ratio: 3.40 (95% CI: 1.54 to 7.61), 2.85 (95% CI: 1.21 - 6.67) and 3.63 (95% CI: 1.17 - 11.20), respectively, whereas the recommended by Dietary Reference Intake. The constipated group had higher urinary osmolality (859 mOsm) than the control group (775 mOsm; p = 0.04). Conclusion: children and adolescents with functional constipation have lower intakes of total water and its plots and increased urine osmolality.
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    Dermatóglifos em crianças com constipação crônica
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2004-03-01) Goshima, Soraya [UNIFESP]; Fagundes-neto, Ulysses [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: The dermatoglyphics can be used to study the participation of genetic factors in many diseases. There is controversy concerning the association between the dermatoglyphic pattern of digital arches and constipation. AIM: To compare the dermatoglyphic patterns among children with and without chronic constipation in relation to the dermatoglyphic patterns and characteristics of stools of their mothers. METHODS: Three groups of children aged from 2 to 12 years and their mothers were studied: 35 patients with severe chronic constipation, 45 children with mild chronic constipation and 51 children without constipation. The fingerprints were taken and evaluated by a datiloscopy technicist and classified in arch, radial loop, ulnar loop, whorl and others. RESULTS: Digital arches were found in 25.7% of severe constipated patients, 28.9% of mild constipated children and in 23.5% of controls. There was not a statistical significant association. Constipation was found in 51,9% (68/131) of the mothers. Arches were found in 35.3% of the mother with constipation and in 42.9% of mothers without constipation. There was a slight association between constipation in children and in theirs mothers (Kappa coefficient = +0,16). CONCLUSION: The dermatoglyphics were not useful to identify the influence of genetic in constipation. There was not association between the dermatoglyphic pattern of digital arch and constipation both in children and in their mothers. Only a slight concordance was found between constipation in children and in their mothers.
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    Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation
    (Associação Brasileira de Divulgação Científica, 2003-06-01) Speridião, Patrícia da Graça Leite [UNIFESP]; Tahan, Soraia [UNIFESP]; Fagundes-Neto, Ulisses [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    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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    Eating practices, nutritional status and constipation in patients with Rett syndrome
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2008-12-01) Schwartzman, Flavia [UNIFESP]; Vítolo, Márcia Regina; Schwartzman, José Salomão; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Federal Faculty of Medical Sciences Department of Public Health; Mackenzie Presbyterian University Program on Development Disorders
    BACKGROUND: Disturbance in chewing, swallowing and digestive motility may predispose to feeding and nutritional abnormalities in patients with Rett syndrome. OBJECTIVE: To evaluate the dietary habits, nutritional status and the prevalence of constipation in patients with classical Rett syndrome. METHODS: Twenty seven female patients between the ages of 2.6 and 21.8 years were studied. The following parameters were evaluated: food register, weight, height and intestinal movement characteristics. Weight and height were compared with the National Center for Health Statistics standards. RESULTS: The inability to ingest solid foods was observed in 80.8% of the patients. A height-to-age deficit was observed in 13 (48.1%) of the girls, being more intense in patients at stage IV. Weight-for-height deficit was found in 10 (37.0%) patients, 15 (55.6%) showed normal weight and 2 (7.4%) were overweight for their height. The median ingestion of energy, according to weight-for-height, was equal to 106.6%. Insufficient iron ingestion was observed in 63.0% and insufficient calcium in 55.6% of the patients. Constipation was verified in 74.1% of the patients and did not show a relationship with the quantity of fiber in the diet. CONCLUSION: Various nutritional problems, as well as, intestinal constipation were observed in these patients with Rett syndrome, and they must be considered in the multidisciplinary therapeutic planning of these individuals.
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    Ensaio clínico randomizado, duplo-cego, controlado sobre o efeito de uma mistura de fibras em crianças com constipação crônica controlada
    (Universidade Federal de São Paulo (UNIFESP), 2011) Weber, Thabata Koester [UNIFESP]; Morais, Mauro Batista de [UNIFESP]
    Objetivo: Avaliar a eficacia clinica e o tempo de transito colonico (TTC) de uma mistura de fibras em criancas com constipacao cronica (CC) controlada apos retirada de laxante e enemas. Metodologia: Neste ensaio clinico randomizado, duplo-cego, controlado por placebo foram incluidas 54 pacientes de quatro a doze anos de idade com constipacao controlada em uso de baixa dosagem de laxante. A utilizacao do laxante foi interrompida quando os pacientes foram incluidos no ensayo clinico. Os pacientes foram randomizados em dois grupos para um periodo de quatro semanas de estudo. Um grupo recebeu uma mistura de fibras composta por seis diferentes tipos de fibras (frutooligossacarideos, inulina, goma arabica, amido resistente, polissacarideo de soja e celulose) e o outro um placebo (maltodextrina). O insucesso terapeutico foi considerado a medida primaria de resultado (necessidade de prescrever laxante oral ou enemas durante o ensayo clinico). Foram consideradas medidas secundarias de resultados a frequencia diaria das evacuacoes, a consistencia das fezes (baseadas na utilizacao da Escala de Bristol para avaliar o formato das fezes) e o tempo de transito colonico total e segmentar. Resultados: As quatro semanas do estudo foram completadas por 20/26 criancas que receberam a mistura de fibras e 24/28 que consumiram placebo. O insucesso terapeutico foi observado em 34,6% (9/26) dos pacientes do grupo mistura de fibras e em 35,7% (10/28) do grupo controle (p=0,933). O incremento medio do aumento da frequencia evacuatoria diaria total do grupo mistura de fibras e controle foram durante o periodo todo de quatro semanas, respectivamente, 0,53 e 0,23 (p=0,014). Os pacientes que receberam a mistura de fibras (60,0%) apresentaram fezes nao endurecidas com maior frequencia comparado aqueles que receberam placebo (16,7%; p=0,003). Nao foi encontrada diferenca entre o tempo de transito colonico total (mediana igual a 50 horas em ambos os grupos) e segmentar. Nenhum efeito adverso grave foi registrado. Conclusao: A mistura de fibras nao preveniu a suspensao definitiva do uso de laxantes ou proporcionou uma reducao do TTC; no entanto, favoreceu o incremento da frequencia evacuatoria e melhorou a consistencia das fezes
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    Excreção de metano no ar expirado por crianças com constipação crônica funcional
    (Universidade Federal de São Paulo (UNIFESP), 2000) Soares, Ana Cristina Fontenele [UNIFESP]; Morais, Mauro Batista de [UNIFESP]
    O metano e o hidrogenio sao gases intestinais que podem estar presentes no ar expirado. Na infancia, a producao de metano tem sido associada com constipacao cronica funcional principalmente nos pacientes com escape fecal. Assim, os objetivo deste estudo foram: 1- pesquisar a producao de metano em pacientes com constipacao cronica funcional com e sem escape fecal; 2- avaliar a producao de metano apos seis semanas de tratamento da constipacao cronica funcional; 3- Avaliar a concentracao de metano no ar expirado antes e apos a evacuacao induzida pelo enema retal. Foram estudados 55 pacientes com constipacao cronica funcional, sendo 38(69,1 por cento) com escape fecal e 17 (30,9 por cento) sem escape fecal, que foram comparados com 10 criancas com habito intestinal normal. A idade dos pacientes e das criancas com habito intestinal normal variou de tres a 13 anos. Foram avaliados, tambem, a concentracao de metano no ar expirado em 12 pacientes com constipacao cronica com impactacao fecal antes e apos a evacuacao induzida por enema retal. Os pacientes com constipacao cronica funcional e as criancas com habito intestinal normal realizaram o teste de hidrogenio e metano no ar expirado apos inGestão de lactulose, para avaliacao do tempo de transito intestinal oro-cecal e o teste do rosa carmim para avaliacao do tempo de transito oro-anal. A producao de metano foi caracterizada pela presenca de metano no ar expirado >3 ppm. O hidrogenio e o metano foram analisados por cromatografia gasosa, com o emprego de um aparelho Quintron©. Producao de metano foi mais frequente nos pacientes com constipacao cronica funcional com escape fecal 32/38 (84,2 por cento) do que nos pacientes com constipacao sem escape fecal 2117 (ll,8 por cento) e nas criancas com habito intestinal normal 0110 (O,O por cento), sendo a diferenca estatisticamente significante. Dos 23 pacientes com constipacao cronica produtora de metano que foram acompanhados por seis semanas, 62,5 por cento deixaram de ser produtores de metano (p
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    Fiber intake, constipation, and overweight among adolescents living in São Paulo city
    (Elsevier B.V., 2006-07-01) Carvalho, Erica Bloes de; Vitolo, Marcia Regina; Gama, Cintia Mendes; Lopez, Fabio Ancona; Taddei, Jose Augusto C.; Morais, Mauro Batista de; Universidade Federal de São Paulo (UNIFESP); Fed Fdn
    Objective: This study evaluated the dietary fiber intake of adolescents in the metropolitan area of São Paulo city and any association between low dietary fiber intake. with constipation and overweight.Methods: in total, 716 adolescents were included within the study, of whom 314 attended private school and 402 attended public school. Evaluation of fiber intake was based on a 24-h daily intake record and a frequency questionnaire. Data concerning bowel movements and height and weight measurements were also taken.Results: Fiber consumption, below that recommended (age + 5), was found in 61.8% and 41.4% (P = 0.000) of girls attending private and public schools, respectively, and in 44.1% and 25.6% of boys (P = 0.001). Adolescents who did not eat beans on more than 4 d/wk presented a higher risk of fiber intake below that recommended (age + 5; P < 0.05), with odds ratios ranging from 10.4 to 14.2 according gender and private or public schooling. Dietary fiber intake below that recommended was associated with a greater risk (P < 0.05) toward overweight in students attending public schooling (odds ratios 2.84 and 2.95 for males and females, respectively). Low dietary fiber intake was not associated with constipation.Conclusion: Intake of beans more than four times per week is associated with the appropriate level of fiber intake. Dietary fiber intake below the recommendation was not associated with constipation but was associated with being overweight among those students attending public schooling. (C) 2006 Elsevier Inc. All rights reserved.
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    Flow-through peritoneal dialysis in neonatal enema-induced hyperphosphatemia
    (Springer, 2010-10-01) Kostic, Dusan; Dutra Rodrigues, Andre Broggin; Leal, Antonio; Metran, Camila; Nagaiassu, Meire; Watanabe, Andreia; Ceccon, Maria Esther; Tannuri, Uenis; Koch, Vera Hermina; Universidade Federal de São Paulo (UNIFESP)
    Fleet enemas are hypertonic solutions with an osmotic action and a high concentration of phosphate. When retained in the human body they have a great toxic potential, causing severe hydro-electrolyte disorders in children, especially in newborns. We report the case of a previously healthy 8-day-old newborn who needed neonatal intensive care treatment after the inadvertent administration of an osmotically active hypertonic phosphate enema. Taking into account that phosphate removal by peritoneal dialysis (PD) strongly depends on total dialysate turnover, we chose continuous flow PD (CFPD) as the treatment option, with a successful outcome. Clinical experience with this dialytic modality is limited to a few case reports in pediatric and adult patients. To the best of our knowledge, we report here the first description of CFPD in the setting of acute phosphate nephropathy in the neonatal period. the modality of PD described here has potential as an alternative management option as it is a highly efficient, methodologically simple, and low-cost method without any need for sophisticated equipment. Physicians and parents should be aware of the adverse effects of a hypertonic phosphate enema and should never use these medications in infants and newborns.
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    Intervenção dietética rica em fibras alimentares e evolução antropométrica de crianças portadoras de constipação crônica funcional
    (Universidade Federal de São Paulo (UNIFESP), 1998) Speridião, Patrícia da Graça Leite [UNIFESP]; Morais, Mauro Batista de [UNIFESP]
    O objetivo deste estudo foi avaliar, prospectivamente, uma intervencao e acompanhar a inGestão alimentar e a evolucao antropometrica de 16 criancas portadoras de constipacao cronica funcional, por um periodo de 90 dias. As criancas foram tratadas com oleo mineral e dieta rica em fibras. A dose terapeutica de fibras alimentares foi o dobro da recomendacao minima da Fundacao Americana de Saúde, ou seja, [(idade em anos + 5 g/dia) x 21.]Com relacao a inGestão de fibra alimentar total, observou-se aumento progressivo nas medianas que passaram de 9,6 gldia na admissao, para 11 g/dia aos 45 dias e 12,5 g/dia aos 90 dias, cujo resultado foi estatisticamente diferente entre o periodo de admissao e 90 dias. Os percentuais de adequacao a recomendacao e adequacao a intervencao dietetica, tambem apresentaram aumento progressivo, sendo respectivamente, 81,9 por cento , 91,0 por cento , 108,8 por cento e 40,9 por cento , 45,5 por cento , 54,4 por cento . O estudo estatistico revelou diferenca significante entre os periodos de admissao e 90 dias, segundo a tabela brasileira de composicao de fibras nos alimentos. Os valores da estimativa de consumo da fibra alimentar total, segundo a tabela da AOAC, apresentou medianas inferiores as encontradas com a tabela brasileira, mas com evolucao semelhante. As medianas de consumo da quantidade de alimentos ingeridos, apresentaram aumento durante o acompanhamento, sendo 838g na admissao, 936,6g aos 45 dias e 1009,6g aos 90 dias de tratamento, porem a diferenca nao atingiu significancia estatistica. Observou-se aumento estatisticamente significante para o percentual de adequacao caiorica, que apresentou medianas de 55,5 por cento , 76,5 por cento e 68,5 por cento , respectivamente, na admissao e aos 45 e 90 dias O consumo de carboidratos, tambem apresentou aumento estatisticamente significantes, cujas medianas foram de 134,5g na admissao, 169,5g aos 45 dias e l6Og aos 90 dias de tratamento. Quanto a evolucao pondero-estaturai e da area muscular do braco, nao se observou diferencas estatisticamente significantes. As medianas da circunferencia braquiai, foram respectivamente, 16,6 cm, 16,8 cm e 16,8 cm na admissao e aos 45 e 90 dias de tratamento. A prega cutanea triciptal apresentou medianas, respectivamente, de 8,5 mm, 10,5 mm e 11,Omm, na admissao e aos 45 e 90 dias de tratamento. As medianas da circunferencia braquial e da prega cutanea triciptai apresentar ...(au)
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    Metano no ar expirado de crianças com constipação crônica funcional
    (Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, 2002-03-01) Soares, Ana Cristina Fontenele [UNIFESP]; Tahan, Soraia [UNIFESP]; Fagundes-neto, Ulysses [UNIFESP]; Morais, Mauro Batista de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Rational- Methane is an intestinal gas which may be excreted in the expired air of about 10% of children. Objective - The aims of this study were to investigate methane production by children with functional chronic constipation and methane concentration in the expired air before and after a bowel movement induced by a phosphate enema. Methods- Seventy-five patients with functional chronic constipation aged from 3 to 13 years were studied. Methane concentration in the expired air was determined using a gas chromatograph (Quintron, model 12i). Methane production was considered present if the breath methane concentration was equal or greater than 3 ppm. Results -Methane production was present in 44 (86,3%) of 51 patients with constipation and fecal soiling versus only 7 (29,2%) of 24 patients with constipation without fecal soiling. After six weeks of therapy for constipation, the number of methane producers decreased by 65,2%. None of the 10 children with normal intestinal habit produced methane. Expired air methane concentration was determined before and after a bowel movement induced by a phosphate enema in 20 patients with impacted stool. From these 20 patients, 12 were methane producers. The median (percentiles 25 and 75 between parenthesis) of methane concentration decreased from 21.5 (15.0-25.5) ppm before to 11.0 (4.0-12.5) ppm after the bowel movement. Conclusion - Methane production was associated with chronic constipation with soiling and decreased when impacted stool decreased.
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    Microbiota benefits after inulin and partially hydrolized guar gum supplementation - a randomized clinical trial in constipated women
    (Aula Medica Ediciones, 2012-01-01) Waitzberg, Dan Linetzky; Pereira, Claudia Cristina Alves [UNIFESP]; Logullo, Luciana da Costa Eduardo; Jacintho, Thiago Manzoni; Almeida, Danielle Fontes de; Silva, Maria de Lourdes Teixeira da; Torrinhas, Raquel Susana Matos de Miranda; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); GANEP Nutr Humana
    Introduction: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation.Objectives: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids.Methods: Our study enrolled 60 constipated female health worker volunteers. Participants reported less than 3 bowel movements per week. Volunteers were randomized to treatment with prebiotic or placebo. Treatment consisted of 3 weeks supplementation with 15 g/d I-PHGG (fiber group) or maltodextrin (placebo group). Abdominal discomfort, flatulence, stool consistency, and bowel movements were evaluated by a recorded daily questionnaire and a weekly interview. Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography, respectively.Results: There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences. Total Clostridium sp significantly decreased in the fiber group (p = 0.046) and increased in the placebo group (p = 0.047). There were no changes in fecal short chain fatty acid profile.Conclusions: Consumption of I-PHGG produced clinical results comparable to placebo in constipated females, but had additional protective effects on gut rnicrobiota by decreasing the amount of pathological bacteria of the Clostridium genera.