Síndrome do Intestino Irritável: manifestação somática que acompanha estados psíquicos?
Arquivos
Data
2013-02-16
Autores
Ambrosina, Mariana Cristina Melaré 
Orientadores
Casetto, Sidnei José
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A síndrome do intestino irritável (SII) é caracterizada como um distúrbio funcional do trato digestivo
para o qual não se demonstrou, até o momento, qualquer alteração metabólica, bioquímica ou
estrutural das vísceras envolvidas, manifestando-se pela acentuação, inibição ou modificação da
função intestinal. O quadro da SII apresenta comumente incapacitação desproporcional aos achados do
exame físico, inexistência de anormalidades laboratoriais e aparente associação com fatores
psicossociais e/ou estresse. Os sintomas típicos da SII são desconforto ou dor abdominal, geralmente
localizados na região baixa do abdômen, associados à alteração do hábito intestinal – constipação,
diarreia ou alternância de uma e de outra. Outros sintomas frequentes são muco nas fezes, urgência
retal, distensão abdominal e flatulência. A síndrome é de evolução crônica com amplo espectro de
gravidade que varia de manifestações clínicas leves a muito exuberantes. Os múltiplos sintomas
associados à SII exercem considerável impacto sobre a qualidade de vida do paciente, limitando a sua
vida social, as oportunidades educacionais e a produtividade no trabalho. O objetivo do estudo foi
investigar se a síndrome do intestino irritável apresenta indicadores de uma organoneurose
(Alexander), de um transtorno psicossomático (Winnicott), ou ainda de um caso de manifestação
somática que acompanha estados psíquicos não patológicos (Winnicott). Utilizou-se como
instrumentos de investigação entrevista semi-estruturada e a realização de um desenho de figura
humana seguida de inquérito sobre o desenho. Este desenho e o inquérito sobre ele foram adotados
como instrumentos com base na teoria de Dolto, a qual afirma que a imagem corporal inconsciente
pode ser considerada a encarnação simbólica inconsciente do sujeito desejante, sendo estruturada pela
comunicação entre sujeitos, e o vestígio memorizado do gozar frustrado, reprimido ou proibido, e esta
imagem pode ser expressa por meio do desenho e do diálogo estabelecido em relação a ele. Foram
constituídos dois grupos, um com 10 sujeitos diagnosticados com a SII e outro grupo, para
comparação, também com 10 sujeitos sem a SII. Os resultados e suas análises apoiaram a hipótese que
a SII poderia ser classificada como uma manifestação somática que acompanha estados psíquicos não
patológicos, pois todos os sujeitos diagnosticados com a SII fizeram algum tipo de relação entre
sintoma físico e vida emocional/psíquica e estariam com a imagem corporal inconsciente preservada,
uma vez que não apresentaram nenhuma dificuldade com relação à expressão de desejos e de ação.
The irritable bowel syndrome (IBS) is characterized as a functional disorder of the digestive tract, which has not been shown any metabolic, biochemical or structural viscera change involved so far. It is manifested by stress, inhibition or modification of function bowel. The SII commonly present disability disproportionate to the findings of physical examination, no laboratory abnormality and apparent association with psychosocial factors and / or stress. Typical symptoms of IBS are abdominal pain or discomfort, usually located in the lower abdomen, associated with changes in bowel habits - constipation, diarrhea or alternating between them. Other common symptoms are mucus in stool, rectal urgency, bloating and flatulence. The syndrome is a chronic disease with a wide spectrum of severity, ranging from mild to very lush clinical manifestations. The multiple symptoms associated with IBS have considerable impact on the patients’ quality of life, limiting their social life, educational opportunities and productivity at work. The aim of this study was to investigate whether irritable bowel syndrome presents indicators of an organoneurose (Alexander), a psychosoxamatic disorder (Winnicott) or a case of somatic manifestation accompanying non pathological psychic states (Winnicott). It was used as research tools interview scripts and the solicitation of drawing of the human figure, followed by an inquire about the drawing. Drawing and inquiry about the drawing were adopted based on Dolto’s theory, which states that the unconscious bodily image can be considered the symbolic uncouscious embodiment of the desiring subject and is structured by communication between subjects. According to this author, the unconscious bodily image can also be regarded as the mnemic vestige of the frustrated enjoyment, repressed or prohibited. Both these aspects of the uncouscious bodily image may express themselves on the drawing and on the relation established in talking about it. Then it was created two groups, one with 10 subjects diagnosed with IBS and another control group, also with 10 subjects, without IBS. The results and their analysis showed that IBS can be classified as a somatic manifestation accompanying non pathological psychic states, because all subjects diagnosed with IBS did some kind of relationship between physical symptoms and emotional/ psychic life, and body image are also unconscious preserved, since they do not present any difficulty about the expression of desires and actions.
The irritable bowel syndrome (IBS) is characterized as a functional disorder of the digestive tract, which has not been shown any metabolic, biochemical or structural viscera change involved so far. It is manifested by stress, inhibition or modification of function bowel. The SII commonly present disability disproportionate to the findings of physical examination, no laboratory abnormality and apparent association with psychosocial factors and / or stress. Typical symptoms of IBS are abdominal pain or discomfort, usually located in the lower abdomen, associated with changes in bowel habits - constipation, diarrhea or alternating between them. Other common symptoms are mucus in stool, rectal urgency, bloating and flatulence. The syndrome is a chronic disease with a wide spectrum of severity, ranging from mild to very lush clinical manifestations. The multiple symptoms associated with IBS have considerable impact on the patients’ quality of life, limiting their social life, educational opportunities and productivity at work. The aim of this study was to investigate whether irritable bowel syndrome presents indicators of an organoneurose (Alexander), a psychosoxamatic disorder (Winnicott) or a case of somatic manifestation accompanying non pathological psychic states (Winnicott). It was used as research tools interview scripts and the solicitation of drawing of the human figure, followed by an inquire about the drawing. Drawing and inquiry about the drawing were adopted based on Dolto’s theory, which states that the unconscious bodily image can be considered the symbolic uncouscious embodiment of the desiring subject and is structured by communication between subjects. According to this author, the unconscious bodily image can also be regarded as the mnemic vestige of the frustrated enjoyment, repressed or prohibited. Both these aspects of the uncouscious bodily image may express themselves on the drawing and on the relation established in talking about it. Then it was created two groups, one with 10 subjects diagnosed with IBS and another control group, also with 10 subjects, without IBS. The results and their analysis showed that IBS can be classified as a somatic manifestation accompanying non pathological psychic states, because all subjects diagnosed with IBS did some kind of relationship between physical symptoms and emotional/ psychic life, and body image are also unconscious preserved, since they do not present any difficulty about the expression of desires and actions.
Descrição
Citação
AMBROSINA, Mariana Cristina Melaré. Síndrome do Intestino Irritável: manifestação somática que acompanha estados psíquicos?. 2013. 84 f. Trabalho de conclusão de curso de graduação (Psicologia) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2013.