便秘新指南 诊疗新规范

Constipation is a common gastrointestinal complaint that can cause significant physical and psychosocial problems. It has been categorized as slow transit constipation, normal transit constipation, and obstructed defecation. Both the definition and patho-physiology of constipation are unclear, but attempts to describe each of the three types have been made. Slow transit constipation, a functional colonic disorder represents15 to 30% of constipated patients.

We investigate 2 diagnostic tests to assess the rectal filling state.Materials and Methods:The rectal filling state was assessed with transabdom-inal ultrasound or with digital rectal examination by 2 independent investigators in children with urological problems before a scheduled diagnostic or surgical urological procedure.

Disordered defecation is at-tributed to pelvic floor dyssynergia. However, clinical observations indicate a spectrum of anorectal dysfunc-tions. The extent to which these disorders are distinct or overlap is unclear; anorectal manometry might be used in diagnosis, but healthy persons also can have abnormal rectoanal pressure gradients during simu-lated evacuation. We aimed to characterize phenotypic variation in constipated patients through high-resolu-tion anorectal manometry.

High-resolution manometry (HRM) is used to measure anal pressures in clinical practice but normal values have not been available. Although rectal evacuation is assessed by the rectoanal gradient during simulated evacuation, there is substantial overlap between healthy people and defecatory disorders, and the effects of age are unknown. We evaluated the effects of age on anorectal pressures and rectal balloon expulsion in healthy women.

The pathophysiology of fecal incontinence is not well understood. Standard or high-resolution anorectal manometry (ARM) provides simple two-dimensional (2D) intra-anal pressure measurements and do not identify radial asymmetry or localize abnormal sphincter function.

BackgroundSevere pediatric slow transit constipation (STC) is commonly due to intrinsic colonic neuro-muscular disease. We sought to correlate neuromus-cular histological phenotypes in pediatric STC with colonic manometric phenotypes using high-resolution manometry (HRM). We tested the hypothesis that failure of motor quiescence (FQ) between bisacodyl-induced high amplitude propagating sequences (HAPSs) might predict neuromuscular pathology.

Despite a lack of supportive data, stool form and stool frequency are often used as clinical surrogates for gut transit in constipated patients. The aim of this study was to assess the correlation between stool characteristics (form and frequency) and gut transit in constipated and healthy adults. Stool form and frequency were correlated with transit times using Spearman's rank correlation.

Introduction and hypothesis Manywomenwithchronic constipation are referred for anorectal function tests (AFT) when they fail initial conservative treatment with lifestyle advice and laxatives.

Chronic constipation (CC) is a common problem in pediatrics and is often the result of obstructed defecation. Objective: To study the feasibility and efficacy of the balloon expulsion test (BET) in the diagnosis and management of children with CC. Methods: Retrospective study comparing BET and High-Resolution Passage of balloon in 1 minute or less was considered normal.Results: Fifteen of the 29 children had a normal BET. Of these, 14 also had an ARM, all of which were normal (except for two cases with a hypertonic baseline anal sphincter).

背景：功能性便秘(FC)常以结肠运动功能障碍为主要表现，结肠传输时(CTT)是反映结肠运动功能的重要指标。目的：探讨不透X线标记物法在评价结肠传输功能以及诊断FC中的作用。方法：采用不透X线标记物法测定32名健康对照者的全结肠传输时间(TCCT)、右半结肠传输时间(RCIT)、左半结肠传输时间(LCIT)和直肠乙状结肠传输时间(RSCIT)。同时检测26例FC患者和32名健康对照者不同时间点钡条排除率。