Denis P
GRAD, Hôpital Charles Nicolle, Rouen.
Contracept Fertil Sex. 1997 Sep;25(9):730-2.
Constipation may be due to drug intake, metabolic and endocrine abnormalities, neurogenic diseases, and gastro-intestinal lesions: in these cases, constipation is only the consequence of another disease. Constipation may be due to dietary or behavioural errors in a lot of patients: in these cases constipation is the consequence of the way of life of the patients. When these two first types of constipation have been ruled out, the constipation is a true constipation, described as chronic idiopathic constipation for which no organic cause may be found. This chronic constipation may be due to a delayed colonic transit secondary either to a colonic inertia in few cases or, at the opposite, to an increased colonic motility in a lot of people often associated with abdominal pain. Chronic constipation may be also due to an outlet obstruction, secondary to a megarectum, a megarecto-sigmoïd, a rectocele, or an abnormal anorectal motility (mainly anismus, often associated with sexual abuse in the past history). No single mechanism can be held responsible for chronic idiopathic constipation, but, whatever the mechanism and the type, constipation is also frequently a way to get help from the doctor.
便秘可能归因于药物摄入、代谢及内分泌异常、神经源性疾病和胃肠道病变：在这些情况下，便秘只是另一种疾病的后果。在许多患者中，便秘可能归因于饮食或行为错误：在这些情况下，便秘是患者生活方式的后果。当排除了这两种类型的便秘后，便秘即为真性便秘，称为慢性特发性便秘，找不到器质性病因。这种慢性便秘可能是由于结肠传输延迟，少数情况下是由于结肠惰性，相反，在很多常伴有腹痛的人当中是由于结肠动力增强。慢性便秘也可能是由于出口梗阻，继发于巨直肠、巨直肠-乙状结肠、直肠膨出或异常的肛肠动力（主要是耻骨直肠肌痉挛性肥厚，既往病史中常与性虐待有关）。没有单一机制可归咎于慢性特发性便秘，但是，无论机制和类型如何，便秘也常常是寻求医生帮助的一种方式。
