[Clinical practice guidelines: Irritable bowel syndrome with constipation and functional constipation in adults: Concept, diagnosis, and healthcare continuity. (Part 1 of 2)].

Autor:	Mearin F; Coordinación de la guía de práctica clínica (GPC), Comité Roma de Trastornos Funcionales Intestinales, Asociación Española de Gastroenterología (AEG), Centro Médico Teknon, Barcelona, España., Ciriza C; Grupo de Trastornos Funcionales, Sociedad Española de Patología Digestiva (SEPD), Hospital Universitario Doce de Octubre, Madrid, España., Mínguez M; AEG y SEPD, Hospital Clínico Universitario, Universitat de Valencia, Valencia, España., Rey E; SEPD Hospital Clínico Universitario San Carlos, Madrid, España., Mascort JJ; Secretaría Científica, Sociedad Española de Medicina de Familia y Comunitaria (semFYC), España. Electronic address: jmascort@semfyc.es., Peña E; Coordinación de Digestivo, Sociedad Española de Médicos de Atención Primaria (SEMERGEN), España., Cañones P; Coordinación de Digestivo, Sociedad Española de Médicos Generales y de Familia (SEMG), España., Júdez J; Departamento de Gestión del Conocimiento, SEPD, España.
Jazyk:	Spanish; Castilian
Zdroj:	Atencion primaria [Aten Primaria] 2017 Jan; Vol. 49 (1), pp. 42-55. Date of Electronic Publication: 2016 Dec 24.
DOI:	10.1016/j.aprim.2016.11.003
Abstrakt:	In this Clinical practice guide, an analysis is made of the diagnosis and treatment of adult patients with constipation and abdominal discomfort, under the spectrum of irritable bowel syndrome and functional constipation. These have an important personal, health and social impact, affecting the quality of life of these patients. In irritable bowel syndrome with a predominance of constipation, this is the predominant change in bowel movements, with recurrent abdominal pain, bloating and frequent abdominal distension. Constipation is characterised by infrequent or difficulty in bowel movements, associated with excessive straining during bowel movement or sensation of incomplete evacuation. There is often no underling cause, with an intestinal functional disorder being considered. They have many clinical and pathophysiological similarities, with a similar response of the constipation to common drugs. The fundamental difference is the presence or absence of pain, but not in a way evaluable way; "all or nothing". The severity depends on the intensity of bowel symptoms and other factors, a combination of gastrointestinal and extra-intestinal symptoms, level of involvement, forms of perception, and behaviour. The Rome criteria diagnose functional bowel disorders. This guide is adapted to the Rome criteria IV (May 2016) and in this first part an analysis is made of the alarm criteria, diagnostic tests, and the criteria for referral between Primary Care and Digestive Disease specialists. In the second part, a review will be made of the therapeutic alternatives available (exercise, diet, drug therapies, neurostimulation of sacral roots, or surgery), making practical recommendations for each one of them. (Copyright © 2016. Publicado por Elsevier España, S.L.U.)
Databáze:	MEDLINE
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