便秘新指南 诊疗新规范

In this article, traditional and novel therapies for chronic con-stipation are reviewed. Traditional laxatives are effective at inducing bowel movements, but efficacy in long-term manage-ment and efficacy on constipation-associated abdominal symp-toms are less well established, with the exception of polyethylene glycol, for which long-term studies confirm sustained efficacy.

Multiple studies have addressed the treatment of chronic constipation in adults in general; however, less guidance is available for treating this condition in older patients.

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.

Because the range of bowel habits and stool types in the community is unknown we questioned 838 men and 1059 women, com-prising 72-2% of a random stratified sample of the East Bristol population. Most of them kept records of three consecutive defecations, including stool form on a validated six point scale ranging from hard, round lumps to mushy.

Chronic constipation in adults is a common and often debilitating problem that may present to almost any medical practitioner as it can have many causes. The most recent Rome criteria provide a useful research and clinical tool for defining chronic, functional con-stipation (box 1).