Avaliação da influência do sistema predominante e do somátorio de sintomas de constipação funcional sobre a terapêutica com fibra dietética
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Data
2007-02-16
Autores
Capelari, Sílvia Maria [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
No presente estudo, foi avaliado a influência do sintoma predominante ou somatório de sintomas da constipação funcional (CF), na resposta desta ao tratamento com fibra dietética (FD). Setenta e um pacientes com diagnóstico de CF foram estudados, sete homens e sessenta e quatro mulheres, idade média de 44 anos. Todos previamente submetidos a rigoroso exame médico, para exclusão de constipação orgânica e a seguir entrevistados por meio de questionário e ficha clinica, onde eram caracterizados os diferentes sintomas da CF (infreqüência evacuatória, fezes ressecadas, esforço evacuatório, sensação de evacuação incompleta e auxílio digital para evacuação). Após esta fase, os pacientes eram colocados num programa de ingestão de fibra a base de farelo de trigo, onde doses crescentes eram adicionadas a cada 15 dias, até que melhorasse a constipação ou o caso fosse considerado como refratário a tratamento. A utilização de fibras apresentou resultados bastante favoráveis na maioria dos constipados (>85%). Não foi possível, contudo, detectar influência evidente dos sintomas predominantes ou do seu somatório, no desfecho do tratamento. Investigação paralela do tempo de duração da constipação, também não revelou associação entre duração e os efeitos da FD. É possível, que a pouca capacidade discriminativa dos diferentes sintomas sobre o efeito da FD na CF, encontrado em nosso estudo, tenha decorrido parcialmente do número limitado de indivíduos participantes de alguns dos subgrupos de sintoma. Outro fator contribuinte relevante, reconhecido por vários autores, é a dificuldade em separar subgrupos homogêneos de desordens funcionais baseado, quer em aspectos clínicos, fisiopatológicos ou psicopatológicos, o que certamente prejudica uma abordagem terapêutica específica.
The aim of this study was to evaluate the influence of the main symptom or the amount of symptoms of functional constipation (FC) in response to the treatment with dietetic fiber (FD). Seventy one FC patients were studied, seven men and sixty four women, 44 years old in average. All patients were submitted to medical evaluation to the exclusion of organic constipation. After this they answered a clinical record and they where classified according to different symptoms (evacuate infrequency, parched fecal, evacuation effort, incomplete evacuation sensation, and digital assist to evacuate). After this phase the patients started a fiber consume program (with wheat bran). The fiber quantity was increased every 15 days, until the patients improved the constipation or the patient case was assumed unsuccessful to the treatment. The fiber consume showed favorable results in most of constipated patients (>85%). The detection of the influence of the predominant symptoms or in the sum of the symptoms to conclude the treatment was not clear. A parallel investigation of constipation time duration did also not reveal association between this time and the fiber effects. It is possible that the small number of individuals in this study did not allow the discrimination of different symptoms in the results with fiber utilization in FC. Another relevant issue is that it is difficult to separate functional disorder homogeneous subgroups based in clinical, physiopathologic or psychopathologic aspects, corroborating many authors. This difficulty also interferes with a suitable therapeutic intervention.
The aim of this study was to evaluate the influence of the main symptom or the amount of symptoms of functional constipation (FC) in response to the treatment with dietetic fiber (FD). Seventy one FC patients were studied, seven men and sixty four women, 44 years old in average. All patients were submitted to medical evaluation to the exclusion of organic constipation. After this they answered a clinical record and they where classified according to different symptoms (evacuate infrequency, parched fecal, evacuation effort, incomplete evacuation sensation, and digital assist to evacuate). After this phase the patients started a fiber consume program (with wheat bran). The fiber quantity was increased every 15 days, until the patients improved the constipation or the patient case was assumed unsuccessful to the treatment. The fiber consume showed favorable results in most of constipated patients (>85%). The detection of the influence of the predominant symptoms or in the sum of the symptoms to conclude the treatment was not clear. A parallel investigation of constipation time duration did also not reveal association between this time and the fiber effects. It is possible that the small number of individuals in this study did not allow the discrimination of different symptoms in the results with fiber utilization in FC. Another relevant issue is that it is difficult to separate functional disorder homogeneous subgroups based in clinical, physiopathologic or psychopathologic aspects, corroborating many authors. This difficulty also interferes with a suitable therapeutic intervention.
Descrição
Palavras-chave
Constipação - Tratamento, Fibras na nutrição humana, Dietas, Constipação funcional, Constipation
Como citar
CAPELARI, Sílvia Maria. Avaliação da influência do sistema predominante e do somátorio de sintomas de constipação funcional sobre a terapêutica com fibra dietética. 2007. 68 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, 2007.