Gleghorn E E, Heyman M B, Rudolph C D
Children's Hospital Medical Center, Oakland, CA.
Clin Pediatr (Phila). 1991 Dec;30(12):669-72. doi: 10.1177/000992289103001203.
Idiopathic constipation and encopresis of childhood are thought to occur when children volitionally withhold stool. Withholding may be prompted by social pressures or by episodes of painful defecation. Repetitive withholding may result in colonic dilatation and colorectal dysfunction. Therapy involves removal of impacted stool, stool softening, and behavioral therapy. The use of enemas in this therapy is widespread but may be counterproductive. A retrospective review of patients treated without enemas revealed 45 patients whose course could be followed for six months. Ninety-eight percent of these had successful initial cleanouts without enemas; 94% had continued success at six months. These results, comparable with other treatment programs, demonstrate that therapy without enemas is a reasonable alternative in the treatment of childhood constipation and encopresis.
儿童特发性便秘和大便失禁被认为是儿童故意憋便时发生的。憋便可能是由社会压力或排便疼痛发作引起的。反复憋便可能导致结肠扩张和结直肠功能障碍。治疗包括清除嵌塞的粪便、软化大便和行为疗法。在这种治疗中灌肠的使用很普遍，但可能会适得其反。一项对未使用灌肠治疗的患者的回顾性研究发现了45例病程可随访6个月的患者。其中98%在没有灌肠的情况下首次成功清理；94%在6个月时持续成功。这些结果与其他治疗方案相当，表明不使用灌肠的治疗是治疗儿童便秘和大便失禁的合理替代方法。
