便秘要因症择药

便秘要因症择药南京江浦县人民医院主任药师张泽宇产生便秘的原因很多，有胃肠功能紊乱引起的，有因患有某种慢性病引起的，也有因使用药物因素引起的，而老年人则多因生理器官功能减退导致产生习惯性便秘。因此，在对便秘的治疗上要针对造成便秘的原因入手，采取不同的措...     

根据便秘类型选择食疗

便秘是指大便秘结不通,或虽有便意而排便困难。女性,尤其是白领职业女性,由于生活节奏快、工作压力大、精神紧张和运动不足等原因,易患便秘和肠疾。久之,对人体健康和容颜都将带来直接的危害。引起便秘的原因虽然很多,但食物品种当是引起便秘的重要因素之一。因此,便秘患者根据     

蛛网膜下腔出血患者便秘原因的分析与护理

蛛网膜下腔出血患者由于绝对卧床休息、情绪紧张、进食减少、不活动等因素，患者易发生便秘。粪便长时间滞留在体内，可引起一系列症状。同时排便时过于用力屏气可引起再出血，进一步加重患者病情。因此，及时发现并解除患者的便秘是护理的重点。为减少意外事件的发生，临床上将患者的便秘原因进行分析，并相应地给予必要的处理，现将结果报告如下。     

三类便秘饮食击破

便秘是指大便秘结不通，或虽有便意，而排便困难。食物品种选择不当是引起便秘的重要因素之一。因此便秘病人根据所表现的不同类型，合理选择食物品种至关重要。     

化解宝宝便秘的九款粥

一般来说,儿童便秘有两方面的原因,一方面是先天性的因素,比如先天性的巨结肠。还有的孩子是由于内分泌原因,比如甲状腺功能低下,肌肉比较松驰,所以会引起便秘,这种便秘从小就有;另一方面是后天性的因素,通常大便比较干燥,排便有一定的困难,孩子感到肛门痛,或者引起肛裂,这些都可以叫做便秘。     

化解宝宝便秘的九款粥

一般来说,儿童便秘有两方面的原因,一方面是先天性的因素,比如先天性的巨结肠.还有的孩子是由于内分泌原因,比如甲状腺功能低下,肌肉比较松驰,所以会引起便秘,这种便秘从小就有;另一方面是后天性的因素,通常大便比较干燥,排便有一定的困难,孩子感到肛门痛,或者引起肛裂,这些都可以叫做便秘.     

润肠通便药蜜饮

喝蜂蜜水治便秘，是自古流传至今的灵效验方。但是，由于引起便秘的病因病机有寒热虚实的不同，因此，单纯饮用蜂蜜水，往往不能达到理想的通便效果。根据临床经验，若能针对引起便秘的不同病因，用蜂蜜加入中药制成药蜜饮，既可发挥中药的作用以治本，又可借助蜂蜜润肠通便的功效而治标，从而迅速有效的解除患者的痛苦。     

老年患者便秘的原因分析与预防护理

便秘是一种常见的症状,在老年人中发病率较高。长期便秘会对身体造成许多不良影响,如可引起肛裂、痔疮、直肠脱垂等肛门疾病,特别是有高血压、冠心病的老年患者,便秘会诱发心绞痛、脑溢血等。因此我们必须加强重视。1便秘的原因分析(1)由于老年人普通牙齿功能不良,长期食用低渣     

便秘原因不同防治方法不同

根据引起便秘的不同原因，基本上可将便秘分为弛缓性便秘、痉挛性便秘、药物性便秘和梗阻性便秘四种。由于产生便秘的原因多样，所以应根据引起便秘的不同原因采取不同的饮食和处理方法。     

旅游中便秘怎么办?

定时排便是一种良好的卫生习惯，它能使大肠保持通畅，保证胃肠功能的正常。可是，在旅游中，有些人由于生活规律被打乱。饮食习惯遭破坏。常会产生暂时性的便秘。便秘可使腹部饱胀、隐痛，严重者还会引起反胃、食欲下降。粪便在大肠肉停留久了，由于水分不断彼肠壁所吸收，粪块便越来越干结，这时，排使就更加困难，形成了恶性循环。少数人还会因粪便硬块压迫骶骨神经，引起骶骨部和大腿后侧隐痛，有痔疮者还可使痔疮复发。因此，不要小看便秘，它不仅使人“负担沉重”，还会造成行动不便，进食不香，精神不爽，使兴致勃勃的旅游大减光彩。[编者按]     

Constipation in long-term care

Constipation is more common in older adults and accounts for increased physician office visits and hospital admissions. There is lack of agreement on the definition of constipation regarding what patients perceive as constipation and what physicians traditionally see as constipation. Constipation is related to multiple factors, and when left untreated or not properly treated, results in complications, such as impaction, even perforation and death. Laxative use increases with age and at times multiple agents are used to relieve symptoms of constipation. Currently the most commonly used laxative is stool softener but it lacks efficacy. From the review of literature, osmotic laxatives are effective in older adults and well tolerated. Psyllium, a bulk laxative, is also effective in the treatment of constipation, while there is limited evidence for stimulants, dioctyl sulfosuccinate, and other bulk laxatives such as calcium polycarbophil and methylcellulose. A new drug, lubiprostone, is a type 2-chloride channel activator and is shown to be effective, safe, and well tolerated in older adults treated for chronic constipation in studies up to a year. It appears to be particularly useful in persons who have recurrent fecal impaction and in those with severe chronic constipation. There is a need for a large-scale trial examining an appropriate cost-effective approach to the management of constipation in the nursing home.     

Gastrointestinal surgery and gastroenterology. IX. Obstipation: etiology and diagnosis

Constipation and disordered defaecation are symptoms, not disease entities. Usually these symptoms are not caused by organic abnormalities, but by disordered motility of the colon and pelvic floor. Both decreased colonic motility (inertia coli) and increased frequency and amplitude of haustrating colonic contractions in the context of an irritable bowel syndrome may lead to constipation. A third important functional cause of constipation is by paradoxical straining of the pelvic floor muscles during (attempts to) defaecate: anismus. In the diagnosis of constipation the primary aim usually is the exclusion of organic disorders. A plain abdominal X-ray and measurement of colonic transit with radiopaque particles will provide information about the severity of the constipation. Defaecography is indicated primarily if disordered faecal expulsion exists. Anorectal manometry is relevant when Hirschsprung's disease is suspected.     

Managing children with constipation: a community perspective

Two clinical nurse specialists explain the nature of constipation in children and how the primary health care team can achieve successful treatment and management strategies for this condition. Constipation in children is a common and often complex problem. It may begin at four months of age in relation to weaning, or at around two years of age in relation to potty training. Constipation can be a distressing problem for the child and the family. Treatment failure rates are high, frequently reflecting poor understanding of the pathophysiology of constipation and inappropriate management. Symptoms include infrequent defaecation, pain and distress and refusal to defaecate. Causes include a poor intake of dietary fibre and fluid, emotional disturbances, possibly intercurrent infection and change in routine. Management of children with constipation includes an increase in dietary fibre and fluids, behaviour modification and laxative medication. For treatment to be effective there should be regular follow-up. Management of this chronic problem by nurses is viewed as effective and acceptable to parents.     

Can Lactose Intolerance Be a Cause of Constipation? A Narrative Review

Lactose intolerance and constipation are common in children and impact everyday life, not only for patients but also their families. Both conditions can be comorbid with other diseases or form a part of their clinical presentation, but constipation is not usually associated with lactose intolerance. The typical symptoms of lactose intolerance include abdominal pain, bloating, flatus, diarrhoea, borborygmi, and less frequently nausea and vomiting. In approximately 30% of cases, constipation can be a symptom of lactose intolerance. Constipation is characterized by infrequent bowel movements, hard and/or large stools, painful defecation, and faecal incontinence, and is often accompanied by abdominal pain. This paper provides a narrative review on lactose intolerance, its epidemiology, pathogenesis, the correlation between lactose intolerance and constipation in children, and potential mechanisms of such association.     

综合干预在抗精神病药物所致便秘中的作用

目的 观察综合干预在抗精神病药物所致便秘患者中的效果.方法 将2012年6月至2013年10月在我院就诊的90例抗精神病药物所致便秘患者分为综合干预组46例和常规治疗组44例.常规治疗组进行常规药物、饮食治疗,综合干预组实施从生活、心理、认知、护理等多方面综合干预,为期3个月.在干预前后采用便秘症状尺度表和便秘状况评估问卷（PAC-QOL）对患者进行评估.结果 综合干预组排便困难、过度用力排便、排便所用时间、频率积分、腹胀积分、症候总积分分别为（2.8±2.1）、（2.2±1.6）、（2.4±1.3）、（2.1±1.7）、（1.5±0.9）、（14.0±8.1）分;改善均优于常规治疗组（t=2.629、3.818、2.328、2.593、2.578、2.913,P＜0.05）.综合干预组PAC-QOL总积分、躯体不适、心理社会不适、担心和焦虑、满意度优于常规治疗组（t=7.499、2.570、5.012、2.249、12.259,P＜0.05）.结论 对抗精神病药物所致便秘患者实施综合干预治疗,可作为促进患者康复的有效措施.     

Cows’ Milk Allergy-Associated Constipation: When to Look for It? A Narrative Review

Constipation is a very common disorder, mostly functional in nature, that may persist for years in up to 35–52% of children. Food allergy prevalence, severity and persistence are increasing over time, and cows’ milk protein is the commonest food allergen recognised to affect gastrointestinal motility in children. There is mounting evidence of the role of cows’ milk (CM) allergy (CMA) in children with constipation. With this narrative review, we aim to provide clinicians with an updated and critical overview of food allergy-associated constipation. We searched Embase, Medline and the Cochrane Library, using keywords related to the topic. Only reviews and studies including children aged 0–17 years that were published in English were considered. Constipation has been reported in 4.6% of infants with CMA; the prevalence of food allergy underlying chronic constipation in children resistant to conventional treatment and presenting to tertiary clinics ranges between 28% and 78%. The identification of predisposing risk factors and of a specific phenotype of food allergy-induced constipation remains elusive. No allergic tests, radiological or motility investigations achieve sufficient sensitivity and specificity to screen children for CMA-related constipation. A 4-week cows’ milk protein (CMP) elimination diet may be considered for children with chronic constipation resistant to conventional treatment and who lack alarm sign/symptoms of organic diseases. In subjects with ameliorated symptoms on CMP elimination, the diagnosis of CMA should be confirmed by a food challenge to avoid an unnecessary protracted diet.     

Are diet and constipation related in children?

Constipation is a common complaint in childhood, and the etiology of many healthcare referrals. Despite literature documenting the high frequency of this problem, there is little research directly relating the food consumed and the eventual stool consistency. There is literature suggesting the importance of adequate fiber intake in children to maintain soft stools. Other dietary modifications actually have not been shown to be helpful or are not based on actual clinical studies. The presence of dietary allergies may also contribute to etiology of constipation. More studies to provide further linkages between diet and constipation are clearly needed.     

Dietary fiber and bowel function in tube-fed patients.

In tube-fed patients, dietary fiber is often used to manage constipation/diarrhea. Dietary fiber consists of water-soluble and insoluble plant compounds that are resistant to digestion by small-bowel enzymes but are fermented to varying degrees by colonic bacteria. Many physiologic effects of fiber may be related to the degree of fermentation. Few controlled studies of fiber-containing tube feedings have been performed. These studies have limitations and are nondefinitive as to whether fiber prevents or controls constipation/diarrhea. Constipation in tube-fed patients has not been shown to respond to mixed soluble/insoluble fiber in the few studies performed to date. Likewise, fiber may be of only limited benefit in controlling diarrhea in acute illness because of such factors as stress or medication. Fiber does play a role in maintaining gut integrity in all patients, whether they have diarrhea or not. Fiber may be recommended as part of a standard tube-feeding regimen to help assure gut mucosal integrity but not specifically to treat constipation/diarrhea. Further studies are necessary before the role of fiber in the management of constipation/diarrhea in tube-fed patients is determined.     

Constipation overview: evaluation and management

Constipation is variably defined, but usually refers to persistent, difficult, infrequent, or seemingly incomplete defecation. An exhaustive list of possible factors may contribute to chronic constipation. Most patients are successfully treated without elaborate, expensive diagnostic procedures, by implementing simple alterations in diet and lifestyle. In the small percentage of patients in whom this fails, a more in-depth analysis of the problem may lead to more specialized forms of therapy. Bowel retraining, or biofeedback, often serves as a foundation for further therapy, but pharmacologic aids or surgery may also be necessary. Unfortunately, results in these patients are not universally optimistic, but patient selection is the key.     

脑血管疾病患者便秘的蒙医药治疗

便秘是脑血管疾病患者常见症状之一。不仅影响脑血管疾病的康复,严重时也能加重病情,甚至威胁生命。所以在临床上应重视脑血管疾病患者的便秘,应用相关有效的措施和蒙药治疗等方法,提高脑血管疾病便秘患者的生活质量。