Beck David E
Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana.
Ochsner J. 2008 Spring;8(1):25-31.
Constipation is a common clinical problem. The evaluation and management of most patients are within the capability of interested, well-trained primary care physicians. The diagnostic evaluation includes an adequate history to exclude treatable etiologies, anatomic evaluation of the colon, and functional studies in refractory patients. Treatment options include medication adjustment and associated disease treatment, followed by a trial of daily fiber or laxatives. Appropriate patients should be referred for consideration of surgical treatment, which usually involves a colectomy and ileoproctostomy for colonic inertia.
便秘是一个常见的临床问题。大多数患者的评估和管理由感兴趣且训练有素的初级保健医生即可胜任。诊断评估包括获取充分的病史以排除可治疗的病因、对结肠进行解剖学评估以及对难治性患者进行功能研究。治疗选择包括调整用药和治疗相关疾病,随后试用每日膳食纤维或泻药。合适的患者应转诊考虑手术治疗,手术通常包括针对结肠无力的结肠切除术和回肠直肠吻合术。