Socio-demographic and intestinal elimination profile in women treated at a health service

Objective: To investigate the profile of intestinal eliminations in women. Method: Cross-sectional study conducted with 41 women seen at a women’s health center in the state of Piauí in Brazil. For data collection, a form was used containing the sociodemographic data and questionnaires that assessed the data on the intestinal elimination pattern with questions based on the Rome IV criteria and the Bristol scale. Results: Of the 41 participants, 56.1% reported consuming one to two servings of fruits or vegetables per day and 51.2% consumed more than two liters of water per day. Regarding the patterns of intestinal elimination, 39% had feces in the Bristol 3 category. As for the Rome IV criteria, 21 (51.2%) women were considered constipated and the frequency of evacuation was statistically significant with the presence of constipation. Conclusion: There was a significant number of women with constipation. There was a need to develop actions that help to cope with the problem and improve the quality of life of this population.


INTRODUCTION
Intestinal constipation is defined as unsatisfactory defecation, characterized by difficulty in passing stools, infrequent or hard stool, or sensation of incomplete evacuation, occurring in isolation or associated with an illness 2 . Although IC is not a threat to the individual's life, it has a negative effect on the quality of life 3 .
To complete the diagnosis of IC, the individual must show at least two or more of the following symptoms listed under the Rome IV criteria for at least three months: hard stools, frequency of bowel movements less than three times a week, effort when defecating, need to perform manual maneuvers, of incomplete bowel sensation movements at least 25% of the time, and/ or sensation of anorectal stool blocking/obstruction 3,4 .
Intestinal constipation is multifactorial and may be associated with systemic or neurological alterations, as well as with the use of inadequate drugs and diets with low fiber consumption, age, female gender, low socioeconomic level, low education level, endocrine and metabolic dysfunctions, physical inactivity, psychiatric disorders and idiopathic causes. In addition, IC can be an initial symptom of severe diseases such as colorectal cancer 5 .
Regarding the management of IC, some strategies can be stimulated and guided by the nurse, especially the enterostomal therapist, such as a high-fiber diet, increased fluid intake, physical activity, use of a bench to improve posture at the time of evacuation, sitting in the toilet after meals preferably always at the same time to establish the routine (taking advantage of the increased gastrocolic reflex), performing the Valsalva maneuver (which consists of taking a deep breath and forcing the muscles of the abdomen and diaphragm down) as well as abdominal massages (massaging the colon from right to left, up and down, for twenty minutes) 6,7 .
The scarcity of official information considering the pattern of bowel and urinary elimination in women may hinder the planning and implementation of strategies and resource allocation for improved nursing care. In this sense, obtaining this information aims to provide better service to the client, expanding the role and professional commitment of the nurse from prevention to the rehabilitation process, applying the mediation of education in the search for autonomy to improve the quality of life of this clientele.
This study aimed to investigate the sociodemographic and intestinal elimination profile of women served in a reference center for women's health.

METHODS
This is a transversal, descriptive research with a quantitative approach. The study was conducted at a Women's Health Center in the State of Piauí in Brazil.
The study population consisted of women who were in the waiting room of the service for consultation. The sample was of a nonprobabilistic type, for convenience, and comprised 41 women attended in the service during the data collection period. Women over the age of 18 were included. The Bristol scale is designed to evaluate and describe the form of fecal content, using graphic methods that represent seven types of feces, according to their shape and consistency, which is useful for patients to evaluate and describe aspects of their feces, facilitating recognition of the severity of constipation 3 . The types of feces described in the instrument are: type 1 (small hard balls, separated like coconuts -hard to get out), type 2 (sausage-shaped, but lumpy), type 3 (sausage-shaped with cracks on its surface), type 4 (sausage or snakeshaped, smooth and soft), type 5 (larger and separate pieces with well-defined edges -easy to remove), type 6 (pasty and fluffy mass with irregular edges), type 7 (totally liquid, without solid pieces) 8

RESULTS
Of the 41 participants of the research, 11 (26.8%) were in the age group between 30 and 39 years, 13   Considering as IC the presence of two or more symptoms of the Rome IV criteria, 21 (51.2%) women were constipated. Table 3 shows the frequency and percentage of each of the symptoms investigated by the Rome criteria.  Regarding the consumption of fruits and vegetables, it was evidenced in this study that the majority consumed from one to two portions of fruits and vegetables per day, coinciding with a study carried out in Portugal that approached 202 people and evidenced that more 50% of the population consumed fruits and vegetables daily 4 . In contrast, a study showed that most participants did not

CONCLUSION
The study showed a significant presence of intestinal constipation among women attended at a women's health care center, even if this was not the reason for seeking the service. Although the relationship between variables has not been statistically proven, the number of women who recall having experienced enuresis in childhood and who consider themselves anxious is relevant.
The result points to a need to work on the issue among groups of women, knowing that it is a group  Supervision, Jaques RMPL.