Tom 10, Nr 1 (2018)
Artykuły
Opublikowany online: 2018-08-13
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Przewlekłe zaparcia — niedoceniany problem kliniczny
Gastroenterologia Kliniczna 2018;10(1):1-13.
Streszczenie
Przewlekłe zaparcia należą do najczęstszych schorzeń układu pokarmowego, na które choruje około 14% populacji na świecie. Do typowych objawów należą zmniejszona liczba wypróżnień (< 3/tydzień), wysiłek podczas defekacji, uczucie niepełnego wypróżnienia, oddawanie twardego stolca. Przewlekłe zaparcia mogą być spowodowane Między innymi wydłużonym czasem pasażu jelitowego stolca, zaburzeniami defekacji lub mieć charakter wtórny do innych chorób. Patofizjologia przewlekłych zaparć jest wieloczynnikowa i nie została do końca wyjaśniona. Diagnoza powinna być ustalona na podstawie standardowo przyjętych kryteriów. Zaawansowane badania diagnostyczne są zalecane jedynie w przypadku nieskuteczności terapii początkowej. Większość pacjentów z przewlekłymi zaparciami powinna być leczona przez lekarza podstawowej opieki zdrowotnej. Terapia obejmuje identyfikację i eliminację wtórnych przyczyn zaparć, zmianę stylu życia (zwiększone spożycie płynów i błonnika, prawidłowa aktywność fizyczna). Leczeniem pierwszego wyboru jest podawanie osmotycznych i stymulujących środków przeczyszczających. Leki prokinetyczne i pobudzające wydzielanie, jak również leczenie chirurgiczne powinny być zarezerwowane dla wyselekcjonowanej grupy pacjentów niereagujących na standardowe leczenie.
Słowa kluczowe: brak
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