首页|Consensus statement AIGO/SICCR: Diagnosis and treatment of chronic constipation and obstructed defecation (part Ⅰ :Diagnosis)

Consensus statement AIGO/SICCR: Diagnosis and treatment of chronic constipation and obstructed defecation (part Ⅰ :Diagnosis)

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Chronic constipation is a common and extremely troublesome disorder that significantly reduces the quality of life,and this fact is consistent with the high rate at which health care is sought for this condition.The aim of this project was to develop a consensus for the diagnosis and treatment of chronic constipation and obstructed defecation.The commission presents its results in a "Question-Answer" format,including a set of graded recommendations based on a systematic review of the literature and evidence-based medicine.This section represents the consensus for the diagnosis.The history includes information relating to the onset and duration of symptoms and may reveal secondary causes of constipation.The presence of alarm symptoms and risk factors requires investigation.The physical examination should assess the presence of lesions in the anal and perianal region.The evidence does not support the routine use of blood testing and colonoscopy or barium enema for constipation.Variousscoring systems are available to quantify the severity of constipation; the Constipation Severity Instrument for constipation and the obstructed defecation syndrome score for obstructed defecation are the most reliable.The Constipation-Related Quality of Life is an excellent tool for evaluating the patient's quality of life.No single test provides a pathophysiological basis for constipation.Colonic transit and anorectal manometry define the pathophysiologic subtypes.Balloon expulsion is a simple screening test for defecatory disorders,but it does not define the mechanisms.Defecography detects structural abnormalities and assesses functional parameters.Magnetic resonance imaging and/or pelvic floor sonography can further complement defecography by providing information on the movement of the pelvic floor and the organs that it supports.All these investigations are indicated to differentiate between slow transit constipation and obstructed defecation because the treatments differ between these conditions.

Slow transit constipationDyssynergic defecationObstructed defecationConstipation scoring systemQuality of lifeAnorectal manometryColon motilityBalloon expulsion testDefecography

Antonio Bove、Filippo Pucciani、Massimo Bellini、Edda Battaglia、Renato Bocchini、Donato Francesco Altomare、Giuseppe Dodi

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Gastroenterology and Endoscopy Unit, Department of Gastroenterology, AORN "A.Cardarelli", 80131 Naples, Italy

Department of Medical and Surgical Critical Care, University of Florence, 50141 Florence, Italy

Gastrointestinal Unit,Department of Gastroenterology, University of Pisa, 56100Pisa, Italy

Gastroenterology and Endoscopy Unit, Cardinal Massaja Hospital, 14100 Asti, Italy

Gastroenterology Unit, M.Bufalini Hospital,47023 Cesena, Italy

Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy

Department of Oncological and Surgical Sciences, University of Padua, 35126 Padua, Italy

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Associazione Italiana Gastroenterologi and Endoscopisti Digestivi Ospedalieri via N ColajanniSocietà Italiana di Chirurgia Colo-Rettale via Medici

4-0019123-10143

2012

10.3748/wjg.v18.i14.1555

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(14)
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