首页|Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (Part Ⅱ :Treatment)

Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (Part Ⅱ :Treatment)

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The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation.There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation.Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre.Osmotic laxatives may be effective in patients who do not respond to fibre supplements.Stimulant laxatives should be reserved for patients who do not respond to osmotic laxatives.Controlled trials have shown that serotoninergic enterokinetic agents,such as prucalopride,and prosecretory agents,such as lubiprostone,are effective in the treatment of patients with chronic constipation.Surgery is sometimes necessary.Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coli who are resistant to medical therapy and who do not have defecatory disorders,generalised motility disorders or psychological disorders.Randomised controlled trials have established the efficacy of rehabilitative treatment in dys-synergic defecation.Many surgical procedures may be used to treat obstructed defecation in patients with acquired anatomical defects,but none is considered to be the gold standard.Surgery should be reserved for selected patients with an impaired quality of life.Obstructed defecation is often associated with pelvic organ prolapse.Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse,but the efficacy and safety of such procedures have not yet been established.

LaxativesProkineticsBiofeedbackPelvic floor rehabilitationOutlet obstructionStapled transanal rectal resectionDelorme operationColectomyPelvic organ prolapseMesh

Antonio Bove、Massimo Bellini、Edda Battaglia、Renato Bocchini、Dario Gambaccini、Vincenzo Bove、Filippo Pucciani

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Gastroenterology and Endoscopy Unit, Department of Gastroenterology, AORN "A.Cardarelli", 80131 Naples, 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 Medical and Surgical Critical Care, University of Florence, 50141 Florence, Italy

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Associazione Italiana Gastroenterologi and Endoscopisti Digestivi Ospedalieri,Via N Colajanni,4,00191Roma,ItalySocietà Italiana di Chirurgia Colo-Rettale,Via Medici,23,10143 Torino,Italy

2012

10.3748/wjg.v18.i36.4994

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(36)
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