Lambiase Christian, D'Alba Lucia, Galeazzi Francesca, Bassotti Gabrio, Consalvo Danilo, Battaglia Edda, Cataudella Giovanni, Neri Maria Cristina, Londoni Claudio, Rossitti Piera, Valenzi Emiliano, Annibale Bruno, Soncini Marco, Parodi Maria Caterina, Bellini Massimo
Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
NIHR Nottingham BRC, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham NG7 2UH, UK.
J Clin Med. 2024 Oct 10;13(20):6047. doi: 10.3390/jcm13206047.
Chronic constipation (CC) is one of the most common disorders of gut-brain interaction (DGBI). The management of CC requires specific skills due to its complex and multifactorial pathophysiology and its multistep treatment. The aims of this study were to evaluate the availability and the use of diagnostic tools for CC in Italy and the therapeutic management of CC by Italian gastroenterologists (GEs). A survey was conducted during the 28th meeting of the Italian Federation of Digestive Disease Societies (FISMAD; Rome, Italy, 11-14 May 2022). The survey explored the presence of a clinic dedicated to DGBIs, the availability and the use of specific diagnostic tools, the routine use of digital rectal examination (DRE), and the therapeutic approach to CC by Italian GEs. The survey was taken by 236 GEs. The most significant results were that 42% of respondents had a clinic dedicated to DGBI in their institute; DRE was regularly performed by 56.8% of GEs when evaluating a CC patient; young GEs (≤40 years) performed DRE less frequently than older ones ( < 0.001); anorectal manometry was available to 44.3% of GEs; balloon expulsion test (BET) was available to 19.1% of GEs; GEs with a clinic dedicated to DGBI had more frequent access to anorectal physiology testing ( < 0.001); diet and lifestyle advice were the most frequently prescribed treatments; and fiber and macrogol were the second and third most prescribed treatments, respectively. The survey provides an interesting picture of CC management by Italian GEs. The results are in line with previous data collected about 10 years ago among Italian GEs ("CHRO.CO.DI.T.E study"); DRE is still rarely performed by Italian GEs (particularly by young GEs). The availability of anorectal physiology testing is still limited, and BET, which could be easily performed in everyday clinical settings, is rarely performed. Lifestyle suggestions, macrogol and fiber are the preferred treatment, as recommended by all guidelines. These results will be useful to identify as yet unmet educational needs and critical issues to improve CC management.
慢性便秘（CC）是肠-脑互动障碍（DGBI）中最常见的病症之一。由于其复杂的多因素病理生理学和多步骤治疗方法，CC的管理需要特定的技能。本研究的目的是评估意大利CC诊断工具的可用性和使用情况，以及意大利胃肠病学家（GEs）对CC的治疗管理。在意大利消化疾病协会联合会第28次会议（FISMAD；意大利罗马，2022年5月11日至14日）期间进行了一项调查。该调查探讨了是否存在专门针对DGBIs的诊所、特定诊断工具的可用性和使用情况、直肠指检（DRE）的常规使用情况，以及意大利GEs对CC的治疗方法。236名GEs参与了此次调查。最显著的结果是，42%的受访者所在机构设有专门针对DGBI的诊所；56.8%的GEs在评估CC患者时会定期进行DRE；年轻的GEs（≤40岁）进行DRE的频率低于年长的GEs（<0.001）；44.3%的GEs可以进行肛门直肠测压；19.1%的GEs可以进行气囊排出试验（BET）；设有专门针对DGBI诊所的GEs更频繁地进行肛门直肠生理测试（<0.001）；饮食和生活方式建议是最常开出的治疗方法；纤维和聚乙二醇分别是第二和第三常开出的治疗方法。该调查提供了意大利GEs对CC管理的有趣情况。结果与大约10年前在意大利GEs中收集的先前数据（“CHRO.CO.DI.T.E研究”）一致；意大利GEs（尤其是年轻的GEs）仍然很少进行DRE。肛门直肠生理测试的可用性仍然有限，而在日常临床环境中可以轻松进行的BET很少进行。生活方式建议、聚乙二醇和纤维是所有指南推荐的首选治疗方法。这些结果将有助于确定尚未满足的教育需求和关键问题，以改善CC的管理。
