便秘

最后审阅: 28 四月 2022
最后更新: 10 九月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 排便次数减少
  • 排便困难
  • 排便不尽感
  • 特别费力
更多 关键诊断因素

其他诊断因素

  • 粪便干结
  • 腹部肿块
  • 提示潜在疾病的体征
  • 肛门直肠病变
  • 直肠指检(DRE)异常
其他诊断因素

危险因素

  • 女性
  • 年龄大于65岁
  • 非洲人血统
  • 社会经济状况较差
  • 家族史
  • 久坐不动的生活方式
  • 低纤维摄入
  • 热量摄入不足
  • 液体摄入不足
  • 外科手术及分娩
  • 诱发便秘的药物
更多 危险因素

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 甲状腺功能检测
  • 血清电解质、钙和镁
  • 血糖
  • 腹部 X 线检查
  • 钡灌肠
更多 首要检查

需考虑的检查

  • 排便粪造影
  • 磁共振排便粪造影
  • 结肠镜检查
  • 结肠传输试验
  • 肛门直肠测压
  • 气囊排出检查
  • 结肠测压
更多 需考虑的检查

治疗流程

急症处理

症状持续时间小于3个月

持续性治疗

症状持续时间大于3个月

服用泻药效果不佳的难治性便秘

撰稿人

作者

Satish Rao, MD, PhD, FRCP (Lon), FACG, AGAF
Satish Rao

Professor of Medicine

Chief, Section of Gastroenterology and Hepatology

Director, Digestive Health Center and Neurogastroenterology and GI Motility

Medical College of Georgia

Georgia Regents University

Augusta

GA

利益声明

SR serves on the advisory board for Smartpill Corporation, Greenwood Pharmaceuticals, Forest Research Institute, and Takeda Pharmaceuticals of North America. SR is an author of a reference cited in this topic.

Amol Sharma, MD, MS

Assistant Professor

Section of Gastroenterology & Hepatology

Augusta University

Augusta

GA

利益声明

AS declares that he is on the advisory board for Ironwood Pharmaceuticals.

鸣谢

Dr Satish Rao and Dr Amol Sharma would like to gratefully acknowledge Dr Humberto Sifuentes and Dr Ashok Attaluri, previous contributors to this topic. HS declares that he has no competing interests. AA is an author of one reference cited in this topic.

同行评议者

Stefan Muller-Lissner, MD

Professor

Abteilung fur Innere Medizin

Park-Klinik Weissensee

Berlin

Germany

利益声明

SML declares that he has no competing interests.

Eamonn M.M. Quigley, MD, FRCP, FACP, FACG, FRCPI

Professor of Medicine and Human Physiology

Department of Medicine

Clinical Sciences Building

Cork University Hospital

Cork

Ireland

利益声明

EMMQ has served as a consultant or on advisory boards for the following companies: Sucampo, Movetis, Norgine, Procter and Gamble, Boehringer Ingelheim, Reckitts Benckiser, Schering, Novartis, Salix, Ironwood, and McNeill Consumer Health and has been paid for his time involved. EMMQ is an author of several references cited in this topic.

Ned Snyder, MD

Chief of Gastroenterology and Hepatology

Kelsey-Seybold Clinic

Adjunct Professor of Medicine

University of Texas Medical Branch

Houston

TX

利益声明

Not disclosed.

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