변비 constipation

소개글

소화기학 - 변비의 기전과 치료

목차

Introduction
Definition
cause
Causes of constipation causes.
Pathophysiology-constipation
Classification
Diagnosis
Treatment of constipation

본문내용

Definition
Constipation is not a disease entity, but a general term that is used to describe the difficulties that patients experience with moving their bowels.
Subjective and objective definitions of constipation include
(1) straining, hard stools or scybala (hard, inspissatedn;
(2) 3 bowel movements per week, daily stool weight 35 g/day, or straining
25% of the time; and
(3) prolonged whole gut or colonic transit.
World J Gastroenterol. 2008 May 7; 14(17): 26312638.
Functional bowel disorders. GASTROENTEROLOGY 2006;130:14801491
Diagnostic Criteria* for Functional Constipation (Rome III criteria)
1. Must include 2 or more of the following:
a. Straining during at least 25% of defecations
b. Lumpy or hard stools in at least 25% of defecations
c. Sensation of incomplete evacuation for at least 25% of defecations
d. Sensation of anorectal obstruction/blockage for at least 25% of defecations
e. Manual maneuvers to facilitate at least 25% of defecations
(eg, digital evacuation, support of the pelvic floor)
f. Fewer than 3 defecations per week



II. Osmotic luxative
삼투 완화제는 삼투성의 활성 이온이나 분자로서 장관에서 이동시켜 배변을 용이하게 한다.
A. Poorly absorbed ions ( = 염류성 완화제)
1. Magnesium sulphate (epsom salt)
2. Magnesium hydroxide (milk of magnesia)
3. Magnesium citrate
4. Sodium phosphate
5. Sodium sulphate (Glauber`s salt)
6. Potassium sodium tartrate (Rochelle salt)
과량복용 시 고마그네슘 혈증을 일으킬 수 있어 신부전 환자에게는 주의를 요한다.
투여 6시간이내 배설
B. Poorly absorbed disaccharides, sugar alcohols ( = 고삼투성 완화제 )
1. Lactulose
2. Sorbitol, mannitol
C. Glycerin
D. Polyethylene glycol
대장 내 균에 의해 대사되어 대사 산물인 젖산이 장운동을 자극하고 삼투 효과를 나타내게 된다.
투여 2~3일 후에 효과.

참고 자료

없음