Bharucha Adil E., Philips Sidney F.
Gastroenterology Research Unit and Enteric Neurosciences Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA.
Curr Treat Options Gastroenterol. 2001 Aug;4(4):309-315. doi: 10.1007/s11938-001-0056-9.
Idiopathic slow-transit constipation is a clinical syndrome predominantly affecting women, characterized by intractable constipation and delayed colonic transit. This syndrome is attributed to disordered colonic motor function. The disorder spans a spectrum of variable severity, ranging from patients who have relatively mild delays in transit but are otherwise indistinguishable from irritable bowel syndrome to patients with colonic inertia or chronic megacolon. The diagnosis is made after excluding colonic obstruction, metabolic disorders (hypothyroidism, hypercalcemia), drug-induced constipation, and pelvic floor dysfunction (as discussed by Wald ). Most patients are treated with one or more pharmacologic agents, including dietary fiber supplementation, saline laxatives (milk of magnesia), osmotic agents (lactulose, sorbitol, and polyethylene glycol 3350), and stimulant laxatives (bisacodyl and glycerol). A subtotal colectomy is effective and occasionally is indicated for patients with medically refractory, severe slow-transit constipation, provided pelvic floor dysfunction has been excluded or treated.
特发性慢传输型便秘是一种主要影响女性的临床综合征，其特征为顽固性便秘和结肠传输延迟。该综合征归因于结肠运动功能紊乱。这种紊乱涵盖了一系列严重程度各异的情况，从传输相对轻度延迟但在其他方面与肠易激综合征难以区分的患者，到患有结肠惰性或慢性巨结肠的患者。在排除结肠梗阻、代谢紊乱（甲状腺功能减退、高钙血症）、药物性便秘和盆底功能障碍（如Wald所讨论的）后做出诊断。大多数患者接受一种或多种药物治疗，包括补充膳食纤维、盐类泻药（氢氧化镁乳剂）、渗透性泻药（乳果糖、山梨醇和聚乙二醇3350）以及刺激性泻药（比沙可啶和甘油）。次全结肠切除术是有效的，对于药物治疗无效的严重慢传输型便秘患者，若已排除或治疗了盆底功能障碍，偶尔会考虑施行该手术。
