Manuseio da Constipação Crônica em Adultos

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Autor: Dra. Lúcia Câmara C. Oliveira

A constipação é uma condição com uma prevalência estimada em até 24% da população. Em alguns subgrupos, como idosos que vivem em asilos, a prevalência pode chegar a 80%. Neste artigo recente de Krogh, Chiaroni e Whitehead, os autores fazem uma revisão dos principais tratamentos utilizados e as evidências em sua utilização.

Krogh K, Chiarioni G, Whitehead W. Management of chronic constipation in adults. United European Gastroenterol J. 2017 Jun;5(4):465-472.
DOI: 10.1177/2050640616663439

Abstract
Chronic constipation (CC) is an extremely common condition with an estimated prevalence of up to 24%. Most patients with CC should be treated in primary care. Changes in lifestyle, including increased intake of dietary fibre, fluid, and exercise, should be attempted in most patients. Osmotic or stimulant laxatives are indicated if there are insufficient effects of lifestyle
changes. Prokinetics and secretagogues should be restricted to those not responding to basic treatment. Anorectal physiology tests and assessment of colorectal transit time are indicated if medical treatment fails or if symptoms indicate severely obstructed defecation. If symptoms indicate an underlying structural disorder, barium or magnetic resonance evacuation proctography is indicated. Biofeedback therapy is effective in patients with dyssynergic defecation. In patients with other evacuation disorders, rectally administered laxatives or transanal irrigation should be attempted. Surgery is restricted to the minority of CC patients with very severe symptoms not responding to conservative treatment.

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