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Inguinal hernia is the most frequently diagnosed hernia and affects approximately one-third of the male population. Several risk factors have been identified, including advanced age, limited physical activity, smoking, and increased intra-abdominal pressure, among others.
The aim of the study was to determine whether constipation is a risk factor for inguinal hernia in the adult population.
A case-control study was conducted at the Department of Surgery of one hospital in the north of Peru, including 121 patients with a confirmed diagnosis of inguinal hernia as cases and 242 patients without such a diagnosis as controls. Inclusion and exclusion criteria were applied, and data were collected through individual interviews using a structured questionnaire that addressed clinical aspects, lifestyles, and the presence of constipation, assessed according to the Rome IV criteria.
Results:
The results revealed significant differences between the groups of patients with and without inguinal hernia in terms of age, sex, and anthropometric characteristics. In addition, statistically significant associations were found between the presence of an inguinal hernia and type 2 diabetes, smoking, and constipation. A multivariate analysis showed that age, male sex, body mass index, high blood pressure, and constipation were significant and independent factors associated with the presence of inguinal hernia.
Constipation is a significant risk factor for inguinal hernia in the adult population. These results support the importance of considering constipation as a risk factor in the evaluation and management of patients with inguinal hernia, highlighting the relevance of adequate clinical care in this group of patients.
There is a lack of valid and specific tools to measure chronic constipation severity in Brazil.
To validate the Constipation Scoring System for Brazilian spoken Portuguese.
Translation, cultural adaptation, and validation itself (reliability and convergent and divergent validation). Translation: definitive version from the original version’s translation and evaluation by specialists. Cultural adaptation: score content analysis of the definitive version, as an interview to patients. Interobserver reliability: application by two researchers on the same day. Intraobserver reliability: same researcher at different times, in a 7-day interval. Divergent validation: non-constipated volunteers. Convergent validation: two groups, good response to clinical treatment and refractory to treatment.
Cultural adaptation: 81 patients, 89% female, with mean age of 55 and seven years of schooling, and overall content validity index was 96.5%. Inter and intraobserver reliability analysis: 60 patients, 86.7% female, mean age of 56 and six years of schooling, and the respective intraclass correlation coefficients were 0.991 and 0.987, p<0.001. Divergent validation: 40 volunteers, 25 male, mean age of 49 years, and the mean global score was 2. Convergent validation of patients with good response to clinical treatment: 47 patients, 39 female, mean age of 60 and six years of schooling, and the pre- and post-treatment scores were 19 and 8, respectively (p<0.001). Convergent validation of refractory to clinical treatment patients: 75 patients, 70 female, mean age of 53 and seven years of schooling, and the global average score was 22.
The Constipation Scoring System (Índice de Gravidade da Constipação Intestinal) validated for the Brazilian population is a reliable instrument for measuring the severity of intestinal chronic constipation.
Several types of complications including constipation, fecal soiling, perianal excoriation, were reported among different types of surgery for Hirschsprung’s disease.
To compare circular and oblique anastomoses following Soave’s procedure for the treatment of Hirschsprung’s disease.
Children who underwent Saove’s pull through procedure with oblique and circular anastomoses were included. Duration of the follow up was two years after surgery. Postoperative complications, such as wound infection, wound dehiscence, peritonitis, fecal soiling, perianal excoriation, were recorded for each patient.
Thirty-eight children underwent oblique anastomoses. Circular ones were done for 32 children. Perianal excoriation was seen in 57.89% and 46.87% of children in oblique and circular group, respectively. Enterocolitis was more frequent in circular (40.62%) than oblique (28.94%) group. Anastomotic stricture was more frequent in circular (15.62%) than oblique (7.89%).
Perianal excoriation was the most common complication among patient in both groups. Oblique anastomoses had fewer complications than circular, and may be appropriate option for patient who underwent Soave’s procedure.
Gastrointestinal disorders are frequently reported in patients with Parkinson’s disease whose disorders reduce the absorption of nutrients and drugs, worsening the clinical condition of patients. However, the mechanisms involved in modifying gastrointestinal pathophysiology have not yet been fully explained.
To evaluate its effects on gastrointestinal motility and the involvement of the vagal and splanchnic pathways.
Male Wistar rats (250-300 g, n = 84) were used and divided into two groups. Group I (6-OHDA) received an intrastriatal injection of 6-hydroxydopamine (21 µg/animal). Group II (control) received a saline solution (NaCl, 0.9%) under the same conditions. The study of gastric emptying, intestinal transit, gastric compliance and operations (vagotomy and splanchnotomy) were performed 14 days after inducing neurodegeneration. Test meal (phenol red 5% glucose) was used to assess the rate of gastric emptying and intestinal transit.
Parkinson’s disease delayed gastric emptying and intestinal transit at all time periods studied; however, changes in gastric compliance were not observed. The delay in gastric emptying was reversed by pretreatment with vagotomy and splanchnotomy+celiac gangliectomy, thus suggesting the involvement of such pathways in the observed motor disorders.
Parkinson’s disease compromises gastric emptying, as well as intestinal transit, but does not alter gastric compliance. The delay in gastric emptying was reversed by truncal vagotomy, splanchnotomy and celiac ganglionectomy, suggesting the involvement of such pathways in delaying gastric emptying.
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