Department of Palliative Medicine, International University of Health and Welfare Narita Hospital, Chiba, Japan,
Department of Gastroenterology, International University of Health and Welfare Graduate School of Medicine, Chiba, Japan,
Digestion. 2024;105(1):40-48. doi: 10.1159/000533548. Epub 2023 Sep 11.
The prevalence of constipation in Japan is estimated to be 2-5%. Constipation is a disease found in older adults. In particular, Japan is an aging society, with 65% of men and 80.5% of women aged 65 years or older accounting for the majority of its population. Chronic constipation may be associated with survival, cardiovascular events, decreased quality of life, and death. This study summarizes the recent findings regarding constipation treatment practice in Japan.
Until recently, the diagnosis of constipation was mainly based on medical interviews; however, with the recent development of handheld ultrasound devices, both physicians and nurses can easily and objectively diagnose fecal retention. Magnesium oxide and stimulant laxatives have been the mainstay treatments; however, since 2012, more than five new drugs for treating constipation have become available in Japan.
Magnesium oxide is less effective in patients who use acid-secretion inhibitors and patients who have undergone total gastrectomy and should be cared for hypermagnesemia. In addition, regular use of stimulant laxatives may lead to colonic inertia and decreased bowel movements; therefore, they should be used only occasionally. The following is an overview of the different uses of conventional and newer laxatives for treating constipation.
据估计,日本的便秘患病率为 2-5%。便秘是一种在老年人中发现的疾病。特别是,日本是一个老龄化社会,65%的男性和 80.5%的女性年龄在 65 岁或以上,占其人口的大多数。慢性便秘可能与生存、心血管事件、生活质量下降和死亡有关。本研究总结了日本最近关于便秘治疗实践的发现。
直到最近,便秘的诊断主要还是基于医学访谈;然而,随着手持式超声设备的最新发展,医生和护士都可以轻松、客观地诊断粪便潴留。氧化镁和刺激性泻药一直是主要的治疗方法;然而,自 2012 年以来,日本有超过五种治疗便秘的新药上市。
氧化镁对使用胃酸分泌抑制剂的患者和接受全胃切除术的患者效果较差,应注意高镁血症。此外,经常使用刺激性泻药可能导致结肠惰性和减少排便;因此,它们只应偶尔使用。以下是传统和新型泻药治疗便秘的不同用途概述。