Hsieh Christine
Thomas Jefferson University, Department of Family Medicine, Philadelphia, Pennsylvania 19107, USA.
Am Fam Physician. 2005 Dec 1;72(11):2277-84.
Constipation is a common complaint in older adults. Although constipation is not a physiologic consequence of normal aging, decreased mobility and other comorbid medical conditions may contribute to its increased prevalence in older adults. Functional constipation is diagnosed when no secondary causes can be identified, such as a medical condition or a medicine with a side effect profile that includes constipation. Empiric treatment may be tried initially for patients with functional constipation. Management of chronic constipation includes keeping a stool diary to record the nature of the bowel movements, counseling on bowel training, increasing fluid and dietary fiber intake, and increasing physical activity. There are a variety of over-the-counter and prescription laxatives available for the treatment of constipation. Fiber and laxatives increase stool frequency and improve symptoms of constipation. If constipation is refractory to medical treatment, further diagnostic evaluation may be warranted to assess for colonic transit time and anorectal dysfunction. Alternative treatment methods such as biofeedback and surgery may be considered for these patients.
便秘是老年人常见的主诉。虽然便秘并非正常衰老的生理后果，但活动能力下降和其他合并症可能导致其在老年人中的患病率增加。当无法确定继发性病因时，如疾病状况或具有包括便秘在内副作用的药物，即可诊断为功能性便秘。对于功能性便秘患者，可首先尝试经验性治疗。慢性便秘的管理包括记录排便性质的大便日记、肠道训练咨询、增加液体和膳食纤维摄入量以及增加身体活动。有多种非处方和处方泻药可用于治疗便秘。纤维和泻药可增加排便频率并改善便秘症状。如果便秘对药物治疗无效，可能需要进一步的诊断评估以评估结肠转运时间和肛门直肠功能障碍。对于这些患者，可考虑生物反馈和手术等替代治疗方法。
