Vitton Veronique, Damon Henri, Benezech Alban, Bouchard Dominique, Brardjanian Sarah, Brochard Charlène, Coffin Benoit, Fathallah Nadia, Higuero Thierry, Jouët Pauline, Leroi Anne-Marie, Luciano Laure, Meurette Guillaume, Piche Thierry, Ropert Alain, Sabate Jean-Marc, Siproudhis Laurent
Gastroenterology Unit, North Hospital, AP-HM, Clinical Interface Unit CRN2M, UMR 7286, Aix-Marseille University.
Physiological Digestive Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon.
Eur J Gastroenterol Hepatol. 2018 Apr;30(4):357-363. doi: 10.1097/MEG.0000000000001080.
Chronic constipation is a common symptom that regularly affects the quality of life of adult patients. Its treatment is mainly based on dietary rules, laxative drugs, perineal rehabilitation and surgical treatment. The French National Society of Coloproctology offers clinical practice recommendations on the basis of the data in the current literature, including those on recently developed treatments. Most are noninvasive, and the main concepts include the following: stimulant laxatives are now considered safe drugs and can be more easily prescribed as a second-line treatment; biofeedback therapy remains the gold standard for the treatment of anorectal dyssynergia that is resistant to medical treatment; transanal irrigation is the second-line treatment of choice in patients with neurological diseases, but it may also be proposed for patients without neurological diseases; and although interferential therapy may be a new promising treatment, it needs further evaluation.
慢性便秘是一种常见症状,经常影响成年患者的生活质量。其治疗主要基于饮食规则、泻药、盆底康复和手术治疗。法国国家结直肠外科学会根据当前文献中的数据提供临床实践建议,包括有关最近开发的治疗方法的建议。大多数治疗方法是非侵入性的,主要概念如下:刺激性泻药现在被认为是安全药物,作为二线治疗更容易开具处方;生物反馈疗法仍然是治疗难治性肛门直肠协同失调的金标准;经肛门灌洗是神经疾病患者的二线治疗选择,但也可用于无神经疾病的患者;尽管干扰疗法可能是一种有前景的新治疗方法,但它需要进一步评估。