长期缺乏身体活动期间便秘的新发情况：关于活动减少引起肠道变化的概念验证研究
New onset of constipation during long-term physical inactivity: a proof-of-concept study on the immobility-induced bowel changes.
作者信息
Iovino Paola, Chiarioni Giuseppe, Bilancio Giancarlo, Cirillo Massimo, Mekjavic Igor B, Pisot Rado, Ciacci Carolina
机构信息
Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
出版信息
PLoS One. 2013 Aug 20;8(8):e72608. doi: 10.1371/journal.pone.0072608. eCollection 2013.
BACKGROUND
The pathophysiological mechanisms underlining constipation are incompletely understood, but prolonged bed rest is commonly considered a relevant determinant.
AIMS
Our primary aim was to study the effect of long-term physical inactivity on determining a new onset of constipation. Secondary aim were the evaluation of changes in stool frequency, bowel function and symptoms induced by this prolonged physical inactivity.
METHODS
Ten healthy men underwent a 7-day run-in followed by 35-day study of experimentally-controlled bed rest. The study was sponsored by the Italian Space Agency. The onset of constipation was evaluated according to Rome III criteria for functional constipation. Abdominal bloating, flatulence, pain and urgency were assessed by a 100mm Visual Analog Scales and bowel function by adjectival scales (Bristol Stool Form Scale, ease of passage of stool and sense of incomplete evacuation). Daily measurements of bowel movements was summarized on a weekly score. Pre and post bed rest Quality of Life (SF-36), general health (Goldberg's General Health) and depression mood (Zung scale) questionnaires were administered.
RESULTS
New onset of functional constipation fulfilling Rome III criteria was found in 60% (6/10) of participants (p=0.03). The score of flatulence significantly increased whilst the stool frequency significantly decreased during the week-by-week comparisons period (repeated-measures ANOVA, p=0.02 and p=0.001, respectively). Stool consistency and bowel symptoms were not influenced by prolonged physical inactivity. In addition, no significant changes were observed in general health, in mood state and in quality of life at the end of bed rest.
CONCLUSIONS
Our results provide evidence that prolonged physical inactivity is relevant etiology in functional constipation in healthy individuals. The common clinical suggestion of early mobilization in bedridden patients is supported as well.
背景
导致便秘的病理生理机制尚未完全明确，但长期卧床休息通常被认为是一个相关决定因素。
目的
我们的主要目的是研究长期缺乏身体活动对新发便秘的影响。次要目的是评估这种长期缺乏身体活动所引起的排便频率、肠道功能及症状的变化。
方法
10名健康男性先进行为期7天的预试验，随后进行35天的实验性控制卧床休息研究。该研究由意大利航天局赞助。根据罗马III功能性便秘标准评估便秘的发生情况。通过100mm视觉模拟量表评估腹胀、肠胃胀气、疼痛及便急情况，通过形容词量表（布里斯托大便分类法、排便难易程度及排便不尽感）评估肠道功能。每日排便情况测量结果汇总为每周得分。在卧床休息前后分别进行生活质量（SF - 36）、总体健康状况（戈德堡总体健康量表）及抑郁情绪（zung量表）问卷调查。
结果
60%（6/10）的参与者出现符合罗马III标准的功能性便秘新发情况（p = 0.03）。在逐周比较期间，肠胃胀气得分显著增加，而排便频率显著降低（重复测量方差分析，分别为p = 0.02和p = 0.001）。粪便稠度和肠道症状不受长期缺乏身体活动的影响。此外，卧床休息结束时，总体健康状况、情绪状态及生活质量均未观察到显著变化。
结论
我们的结果表明，长期缺乏身体活动是健康个体功能性便秘的相关病因。这也支持了对卧床患者尽早活动的常见临床建议。
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