Kuijpers J H
Department of Surgery, Academic Hospital St. Radboud, Catholic University, Nijmegen, The Netherlands.
Neth J Surg. 1991;43(6):213-7.
Constipation and defaecation may be considered as the last taboo. The inability of defaecate or to achieve this only by digital evacuation has never been a popular topic among patients and doctors. Application of tests from the colorectal laboratory has made it possible to study the function of the different parts of the colon and the mechanism of continence. Two types of constipation can be distinguished: I slow transit, which is probably a systemic disease, and 2 functional colonic outlet obstruction due to abnormal pelvic floor function during defaecation straining, which is likely to be a behavioural disorder. Since 30 per cent of the patients with constipation have a normal total colonic transit time, constipation is not merely related to a low frequency of defaecation, but should be defined as a difficult and painful rectal evacuation which may even be impossible over several days.
便秘和排便可能被视为最后的禁忌。无法排便或只能通过手指抠挖才能排便，这在患者和医生中从来都不是一个热门话题。结直肠实验室检测方法的应用使得研究结肠不同部位的功能以及节制机制成为可能。便秘可分为两种类型：一是慢传输型，这可能是一种全身性疾病；二是功能性结肠出口梗阻，是由于排便用力时盆底功能异常所致，这可能是一种行为障碍。由于30%的便秘患者结肠总传输时间正常，所以便秘不仅仅与排便频率低有关，而应定义为直肠排空困难且伴有疼痛，甚至可能连续数天无法排便。
