最近审阅: 6 十一月 2020
最近更新: 01 二月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 肛门直肠、神经系统或脊柱异常病史,或胃肠道手术史
  • 粪便污染或腹泻
  • 便秘
  • 肛周皮肤刺激
  • 直肠检查结果异常
  • 脊柱畸形
  • 无力和反射减弱或消失

其他诊断因素

  • 行为问题
  • 排便疼痛
  • 腹痛/绞痛
  • 姿势-臀部收缩
  • 遗尿
  • 肛门直肠畸形
  • 异常的腹部检查
  • 潜在疾病史

危险因素

  • 慢性便秘
  • 男性
  • 年龄: 5 岁至 6 岁
  • 膳食纤维缺乏
  • 液体摄入不足
  • 排便训练延迟或不足
  • 肛门直肠畸形
  • 先天性巨结肠
  • 脊柱异常
  • 由于家庭压力事件导致的心理或行为问题
  • 精神障碍
  • 过度用药

诊断性检查

需考虑的检查

  • 即时钡灌肠
  • 脊柱 X 线
  • 脊柱 MRI 检查
  • 不透 X 线标志物法
  • 结肠直肠测压检查
  • 直肠活检
  • 血清促甲状腺激素水平
  • 血清游离 T4 水平
  • 汗液氯化物检测
  • 组织谷氨酰胺转移酶免疫球蛋白 A
更多 需考虑的检查

治疗流程

撰稿人

Linda S. Nield

Professor of Pediatrics

West Virginia University School of Medicine

Morgantown

WV

利益声明

LSN is an author of a reference cited in this topic.

Associate Professor of Pediatrics

Section Chief of Pediatric Gastroenterology, Hepatology and Nutrition

West Virginia University School of Medicine

Morgantown

WV

利益声明

BDR declares that he has no competing interests.

Dr Linda S. Nield and Dr Brian D. Riedel would like to gratefully acknowledge Dr Uwe Blecker, a previous contributor to this topic.

利益声明

UB declares that he has no competing interests.

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Assistant Professor

Division of Pediatric Urology

Monroe Carell Jr. Children's Hospital at Vanderbilt

Nashville

TN

利益声明

JCT declares that he has no competing interests.

Consultant Paediatrics Gastroenterologist

Western Sussex Hospitals NHS Trust

Chichester

Honorary Consultant Paediatric Gastroenterologist

Royal Alexandra Children's Hospital

Brighton and Sussex University Hospitals

Brighton

UK

利益声明

DCAC has received research grants, consultancy fees, and reimbursement of conference expenses from Norgine UK, the manufacturer of Movicol. He is the author of a systematic review of polyethylene glycol-based laxatives; convenor of the Paris Consensus on Constipation Terminology Group; and external advisor of the National Institute for Health and Care Excellence paediatric constipation guideline development group.

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