Gastroenterology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore, Policlinico, Milan, Italy.
Dig Liver Dis. 2013 Nov;45(11):886-93. doi: 10.1016/j.dld.2013.03.016. Epub 2013 Apr 30.
Chronic constipation is a very common symptom that is rarely associated with life-threatening diseases, but has a substantial impact on patient quality of life and consumption of healthcare resources. Despite the large number of affected patients and the social relevance of the condition, no cost-effectiveness analysis has been made of any diagnostic or therapeutic algorithm, and there are few data comparing different diagnostic and therapeutic approaches in the long term. In this scenario, increasing emphasis has been placed on demonstrating that a number of older and new therapeutic options are effective in treating chronic constipation in well-performed randomised controlled trials, but there is still debate as to when these therapeutic options should be included in diagnostic and therapeutic algorithms. The aim of this review is to perform a critical evaluation of the current diagnostic and therapeutic options available for adult patients with chronic constipation in order to identify a rational patient approach; furthermore we attempt to clarify some of the more controversial points to aid clinicians in managing this symptom in a more efficacious and cost-effective manner.
慢性便秘是一种非常常见的症状，很少与危及生命的疾病有关，但对患者的生活质量和医疗资源的消耗有很大的影响。尽管受影响的患者人数众多，且该疾病具有重要的社会意义，但尚未对任何诊断或治疗方案进行成本效益分析，并且在长期内比较不同诊断和治疗方法的数据也很少。在这种情况下，越来越强调在表现良好的随机对照试验中证明许多较旧和较新的治疗选择在治疗慢性便秘方面是有效的，但对于何时应将这些治疗选择纳入诊断和治疗方案仍存在争议。本综述的目的是对目前可用于治疗慢性便秘的成年患者的诊断和治疗选择进行批判性评估，以确定合理的患者治疗方法；此外，我们还试图澄清一些更具争议的观点，以帮助临床医生以更有效和更具成本效益的方式管理这种症状。
