Primer consenso centroamericano y del Caribe del síndrome de intestino irritable
DOI:
https://doi.org/10.52787/agl.v53i2.272Palabras clave:
Síndrome de intestino irritable, diarrea, estreñimiento, consenso, criterios diagnósticos, tratamiento, CentroaméricaResumen
El síndrome de intestino irritable sigue siendo uno de los trastornos gastrointestinales más comunes observados por los médicos, tanto en la atención primaria como en la secundaria. Se han logrado avances significativos en la comprensión de su compleja fisiopatología, lo que resulta en su reclasificación como un trastorno de la interacción intestino-cerebro, en lugar de un trastorno gastrointestinal funcional. La condición afecta a entre el 5% y el 10% de la población y, en la mayoría de los casos, se caracteriza por tener una evolución con recaídas y remisiones. El diagnóstico se puede hacer sobre la base de la historia clínica con un uso limitado y juicioso de las investigaciones, a menos que se presenten síntomas de alarma, como pérdida de peso o sangrado rectal, o que haya antecedentes familiares de enfermedad inflamatoria intestinal o enfermedad celíaca. Los pilares del tratamiento incluyen la educación del paciente sobre la afección, los cambios en la dieta, la fibra soluble y los medicamentos antiespasmódicos. Otros tratamientos tienden a estar reservados para personas con síntomas refractarios e incluyen neuromoduladores centrales, secretagogos intestinales, medicamentos que actúan sobre los receptores opioides o 5-hidroxitriptamina o serotonina (5-HT), o antibióticos mínimamente absorbidos (todos los cuales se seleccionan de acuerdo con el hábito intestinal predominante), así como terapias psicológicas. Este consenso es el resultado del trabajo en conjunto de representantes de la Asociación Centroamericana y del Caribe de Gastroenterología, desarrollado de forma virtual, con el objetivo de presentar una serie de recomendaciones adaptadas a la realidad de la región y que sirvan de referencia en la práctica clínica.
Citas
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Derechos de autor 2023 Jorge Antonio Galdámez Estrada, Luis Aguilar Paiz, Gianna Minerva Blanco, Sandra Chaves Monge, León de Mezerville Cantillo, Pablo Navarro Castillo, Isaac Quintero, Eliam del Pilar Rivas Polanco, Marco Antonio Sánchez Hernández, Edder Sandoval, Jorge Suazo Barahona, Edwin Vicente Pérez, Mariel Mejía, Silvia María Portillo, Luis Enrique Jerez González, José María Remes Troche, Max Julio Schmulson Wasserman
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