Constipação intestinal, impactação fecal e tempo de trânsito colônico em crianças e adolescentes com fibrose cística
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Data
2018-03-27
Autores
Sillos, Marcela Duarte de [UNIFESP]
Orientadores
Morais, Mauro Batista De [UNIFESP]
Tipo
Dissertação de mestrado
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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.
Objectives: 1) To study the prevalence of constipation and fecal impaction among children and adolescents with cystic fibrosis; 2) To compare the total and segmental colonic transit time in cystic fibrosis patients with and without constipation and patients with and without fecal impaction. Methods: Crosssectional study including children and adolescents with cystic fibrosis followed up at a reference centre. Constipation was diagnosed according to the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) definition. Fecal impaction was assessed by abdominal radiographs interpretation according to the Barr score. Colonic transit time was calculated by using radiopaque markers. Results: Constipation was observed in 44.1% of children and adolescents with cystic fibrosis mostly female patients (p=0.007). High prevalence of fecal impaction (57.1%) was found in patients with and without constipation (p=0.445). Constipated patients presented longer total (p=0.028) and right colonic transit time (p=0.012). Colonic dysmotility (right colonic stasis) was observed in 13.3% of constipated patients. Colonic transit time was similar in patients with and without fecal impaction. Conclusions: Constipation was diagnosed in almost half the pediatric patients with cystic fibrosis. Fecal impaction, identified in most patients, has not been associated with constipation. Cystic fibrosis patients with constipation had longer total and right colonic transit time, whereas patients with and without fecal impaction had similar colonic transit time.
Objectives: 1) To study the prevalence of constipation and fecal impaction among children and adolescents with cystic fibrosis; 2) To compare the total and segmental colonic transit time in cystic fibrosis patients with and without constipation and patients with and without fecal impaction. Methods: Crosssectional study including children and adolescents with cystic fibrosis followed up at a reference centre. Constipation was diagnosed according to the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) definition. Fecal impaction was assessed by abdominal radiographs interpretation according to the Barr score. Colonic transit time was calculated by using radiopaque markers. Results: Constipation was observed in 44.1% of children and adolescents with cystic fibrosis mostly female patients (p=0.007). High prevalence of fecal impaction (57.1%) was found in patients with and without constipation (p=0.445). Constipated patients presented longer total (p=0.028) and right colonic transit time (p=0.012). Colonic dysmotility (right colonic stasis) was observed in 13.3% of constipated patients. Colonic transit time was similar in patients with and without fecal impaction. Conclusions: Constipation was diagnosed in almost half the pediatric patients with cystic fibrosis. Fecal impaction, identified in most patients, has not been associated with constipation. Cystic fibrosis patients with constipation had longer total and right colonic transit time, whereas patients with and without fecal impaction had similar colonic transit time.
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Citação
SILLOS, Marcela Duarte de. Constipação intestinal, impactação fecal e tempo de trânsito colônico total e segmentar em crianças e adolescentes com fibrose cística. 2018. 99 f. Dissertação (Mestrado em Pediatria e Ciências Aplicadas à Pediatria) -Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2018.