Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- dor abdominal
- alteração dos hábitos intestinais associados à dor
- inchaço ou distensão abdominal
- exame do abdome normal
Fatores de risco
- abuso físico e sexual
- transtorno do estresse pós-traumático (TEPT)
- idade <50 anos
- sexo feminino
- infecção entérica prévia
- história familiar
- estresse familiar e no trabalho
Investigações diagnósticas
Investigações a serem consideradas
- exame de sangue oculto nas fezes
- teste imunoquímico fecal (FIT) quantitativo
- testes sorológicos para doença celíaca
- calprotectina fecal
- lactoferrina fecal
- proteína C-reativa sérica
- velocidade de hemossedimentação (VHS)
- fator de crescimento de fibroblastos 19 sérico
- Teste de taurina-ácido homocólico marcado com selênio (SeHCAT)
- Coleta de fezes de 48 horas para ácidos biliares totais
- ensaio empírico do ligante de ácidos biliares
- teste do hidrogênio/metano no ar expirado
- exames de fezes para Giardia lamblia
- radiografia abdominal simples
- colonoscopia
- sigmoidoscopia flexível
Algoritmo de tratamento
Colaboradores
Autores
Ned Snyder, MD, MACP, AGAF
Professor of Medicine
Baylor College of Medicine and Marion DeBakey VA Hospital
Houston
TX
Adjunct Professor of Medicine
University of Texas Medical Branch
Galveston
TX
Declarações
NS declares that he is a member on the board of the Kelsey Research Foundation, a non-profit organization. Kelsey Research Foundation has received and awarded private grants for the study of the microbiome in several diseases, including irritable bowel syndrome.
Revisores
Douglas Drossman, MD
Professor of Medicine and Psychiatry
School of Medicine
Co-Director
UNC Center for Functional GI and Motility Disorders
Chapel Hill
NC
Declarações
DD declares that he has no competing interests.
Simon McLaughlin, MBBS
Research Fellow
Department of Gastroenterology
St Mark's Hospital
Northwick Park
Harrow
UK
Declarações
SM declares that he has no competing interests.
Horace Williams, MBBS
Clinical Research Fellow
Division of Medicine
Imperial College
London
UK
Declarações
HW declares that he has no competing interests.
Referências
Principais artigos
Longstreth GF, Thompson WG, Chey WD, et al. Functional bowel disorders. Gastroenterology. 2006 Apr;130(5):1480-91.Texto completo Resumo
Lacy BE, Mearin F, Chang L, et al. Bowel disorders. Gastroenterology. 2016 May;150(6):1393-407. Resumo
Lacy BE, Pimentel M, Brenner DM, et al. ACG clinical guideline: management of irritable bowel syndrome. Am J Gastroenterol. 2021 Jan 1;116(1):17-44.Texto completo Resumo
Smalley W, Falck-Ytter C, Carrasco-Labra A, et al. AGA clinical practice guidelines on the laboratory evaluation of functional diarrhea and diarrhea-predominant irritable bowel syndrome in adults (IBS-D). Gastroenterology. 2019 Sep;157(3):851-4.Texto completo Resumo
Chey WD, Hashash JG, Manning L, et al. AGA clinical practice update on the role of diet in irritable bowel syndrome: expert review. Gastroenterology. 2022 May;162(6):1737-45.e5.Texto completo Resumo
Dionne J, Ford AC, Yuan Y, et al. A systematic review and meta-analysis evaluating the efficacy of a gluten-free diet and a low FODMAPs diet in treating symptoms of irritable bowel syndrome. Am J Gastroenterol. 2018 Sep;113(9):1290-300. Resumo
Chang L, Sultan S, Lembo A, et al. AGA clinical practice guideline on the pharmacological management of irritable bowel syndrome with constipation. Gastroenterology. 2022 Jul;163(1):118-36.Texto completo Resumo
Lembo A, Sultan S, Chang L, et al. AGA clinical practice guideline on the pharmacological management of irritable bowel syndrome with diarrhea. Gastroenterology. 2022 Jul;163(1):137-51.Texto completo Resumo
Artigos de referência
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