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TRABAJO ORIGINAL

&DUDFWHUtVWLFDVFOtQLFDVGHOVtQGURPHGHLQWHVWLQRLUULWDEOH HQSDFLHQWHVGHGRVFHQWURVDVLVWHQFLDOHV Clinical characteristics of the irritable bowel syndrome in patients from two medical centers Franco LeĂłn-JimĂŠnez1, Fernando Cubas-Benavides2

RESUMEN OBJETIVO. Se realizĂł un estudio para conocer las caracterĂ­sticas de los pacientes con sĂ­ndrome de intestino irritable (SII). MATERIAL Y MÉTODOS. Estudio descriptivo, prospectivo y transversal, con una encuesta en 77 pacientes con diagnĂłstico de SII, por los criterios ROMA III, en la ciudad de Chiclayo, capital del departamento de Lambayeque, en la costa norte del PerĂş. RESULTADOS. El 93,5% de pacientes fue del sexo femenino; las ocupaciones mĂĄs frecuentes, los estudiantes y las amas de casa (30% y 28%, respectivamente). La media del tiempo de enfermedad fue de 62,5 meses. El lugar del dolor mĂĄs frecuente fue la pelvis (18,2%), seguido del epigastrio (14,3%); el dolor cĂłlico fue el tipo de dolor mĂĄs frecuente (25,0%). La variedad de SII mĂĄs frecuente fue la de constipaciĂłn (47,0%). Otros trastornos asociados IXHURQVXHxR  OXPEDJRFUyQLFR  GHSUHVLyQPD\RU  PLJUDxD  \Ă€EURPLDOJLD   CONCLUSIONES. El dolor pĂŠlvico de tipo cĂłlico y la constipaciĂłn fueron las caracterĂ­sticas principales del SII, y hubo una alta frecuencia de coexistencia de enfermedades funcionales, en especial trastornos del sueĂąo y lumbago crĂłnico. PALABRAS CLAVES. SĂ­ndrome de intestino irritable, EstreĂąimiento, Dolor pĂŠlvico, Trastorno digestivo funcional.

ABSTRACT OBJECTIVE. It was carried out a study in order to determine the clinical characteristics of the irritable bowel syndrome (IBS) patients. MATERIAL AND METHODS. A descriptive, prospective and transversal study survey was done in 77 patients with diagnosis of IBS by ROMA III criteria, from two medical centers, in Chiclayo, capital city of the department of Lambayeque, Peruvian northern coast. RESULTS. 93,5% of the patients were women; the students and housewives represented the 30,0% and 28,0%; the median time of illness was 62,5 months; 18,2% had pelvic pain and epigastric pain (14,3%); colicky pain and constipation were was the most frequent complaints among them. Related complaints were insomnia, FKURQLF EDFN SDLQ PD\RU GHSUHVVLRQ PLJUDLQH DQG ÀEURmyalgia were: 93,5%, 79,2%, 50,6%, 32,5% and 14,3%, respectively). Conclusions. Pelvic colic pain and constipation

1. MĂŠdico internista. Universidad CatĂłlica Santo Toribio de Mogrovejo, Chiclayo. 2. MĂŠdico gastroenterĂłlogo. Universidad CatĂłlica Santo Toribio de Mogrovejo, Chiclayo.

were the most characteristics complaints among our patients of these patients, and, there was a high frequency of related complaints, mainly sleep disorders and chronic lumbago.

KEY WORDS. Irritable bowel syndrome, Constipation, Pelvic pain, Functional digestive disorder.

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Tabla 1. Manifestaciones gastrointestinales y extradigestivas y comorbilidad en pacientes con síndrome de intestino irritable Presente Ausente N % N % ‡ Síntomas gastrointestinales – Tenesmo – – Pujo – Disquesia – Dolor (calma con evacuación) – Mucosidad – Distensión abdominal – Pirosis – Epigastralgia – Hiporexia – Eructos – Flatos ‡ Síntomas extradigestivos – Palpitaciones – Polo matutino – Precordalgia – Sudoración de manos – Pérdida de peso ‡ Comorbilidad – Insomnio – Migraña – Depresión – Lumbago – Fibromialgia

Total

65 61 36 45 23 59 43 57 26 31 42

86,6 80,2 65,4 80,3 30,6 83,1 58,1 78,1 35,6 40,8 56,0

10 15 19 11 52 12 31 16 47 45 33

13,4 18,8 34,6 19,7 69,4 16,9 41,9 21,9 64,4 59,2 34,9

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65 49 47 35 41

86,6 70,0 64,4 47,9 55,4

10 21 26 38 33

13,4 30,0 35,6 52,1 44,6

75 70 73 73 74

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97,3 33,3 50,6 79,2 15,3

2 50 38 16 61

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19. Frank K, Kleinman L, Rentz A, et al. Health-related quality of life associated with irritable bowel syndrome: comparison with other chronic diseases. Clin Ther 2002;24:675-689. 20. Gralnek IM, Hays RD, Kilbourne A, et al. The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology 2000;119: 654-660. 21. Campos HG, Villarreal MJ, Cornejo ZC, y col. Asociación entre síndrome de intestino irritable y síntomas depresivos en una población de nivel socioeconómico alto de Lima. Rev Gastroenterol Perú 2001;21(3):198-204. 22. Saito YA, Schoenfeld P, Locke GR. The epidemiology of irritable bowel syndrome in North America: A systematic review. Am J Gastroenterol 2002;97:1910-1915. 23. Hahn BA,Yan S, Strassels S. Impact of irritable bowel syndrome on quality of life and resource use in the United States and United Kingdom. Digestion 1999;60:77-81. 24. Longstreth GF, Yao JF. Irritable bowel syndrome and surgery: a multivariate analysis. Gastroenterology 2004;126:1665-1673. 25. Manning AP, Thompson WG, Heaton KW, et al. Towards positive diagnosis of the irritable bowel syndrome. BMJ 1978; 2:653-4. 26. Drossman DA. The functional gastrointestinal disorders and the Roma III process. In: Drossman DA, Coraziari E, Delvaux M, Spiller RC, Talley NJ, Thompson WG and Whitehead WE (ed.). ROME III The Functional Gastrointestinal Disorders. 3rd. ed.,Virginia USA: Degnon Associates Mc Lean, 2006, pp 1-29. 27. El-serag HB, Pilgrim P, Schoenfield P. Systematic review: natural hystory of Irritable Bowel Syndrome. Aliment Pharmacol Ther 2004;19:861-870. 28. Drossman DA, Camillero M, Mayer EA et al AGA technical review on irritable bowel síndrome. Gastroenterology 2002;123:2108-2131. 29. León Jiménez FE. Perfil epidemiológico y clínico de los pacientes con fibromialgia atendidos en el consultorio externo del Hospital de la Solidaridad de Chiclayo durante el mes de junio del 2008. Presentado al XX Congreso peruano de Medicina Interna, Lima, 2008. 30. Drossman DA. Do psychosocial factors define symptom severity and patient status in irritable bowel syndrome? Am J Med 1999;107:41-50. 31. Koloski NA, Talley NU, Boyce PM. Predictors of health care seeking for irritable bowel syndrome and non ulcer dyspepsia: a critical review of literature on symptom and psychosocial factors. Am J Gastroenterol 2001;96:1340-1349. 32. Cash BD, Andrews AH, Lee DH, Smith JH, Kim CH, Saad R, et al.Yield of diagnostic testing in patients with suspected irritable bowel syndrome (IBS): A prospective, US multi-center trial. Gastroenterology 2006;130 (suppl 2): A-111-112. 33. Camilleri M. Management of the Irritable Bowel Syndrome. Gastroenterology 2001;120:652-68.

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ABSTRACT INTRODUCCIÓN TRABAJO ORIGINAL were the most characteristics complaints among our patients of these patients, and, there was a high...

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