The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Treatment of Constipation

변비의 치료

  • Park, Moo-In (Department of Internal Medicine, Kosin University College of Medicine)
  • 박무인 (고신대학교 의과대학 내과학교실)
  • Published : 2011.05.01
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Abstract

Constipation is a common gastrointestinal disease affecting approximately 16.5% of the population in Korea. Systemic diseasessuch as hypothyroidism or colon cancer and drugs can cause constipation in some patients with constipation, there is no obstructivemucosal or structural cause in the vast majority of patients with constipation. Evaluation for secondary causes of constipation isneeded to provide appropriate management. Once secondary causes have been excluded, constipation may be classified into normalor slow transit constipation, evacuation disorder of the spastic or flaccid varieties, or both. Treatment of chronic constipation basedon the underlying pathophysiology is generally successful. The aims of this review are to discuss the management of functionalconstipation based on guidelines for the treatment of constipation published in Korean Journal of Gastroenterology in 2011:lifestyle changes; bulking agents and stool softeners; osmotic agents; stimulant laxatives; prokinetics; biofeedback and surgicaltreatments. Exercise and dietary fiber are helpful in some patients with constipation. Laxatives including bulking agents, stoolsofteners, osmotic agents, stimulant laxatives have been found to be more effective than placebo at relieving symptoms ofconstipation. New enterokinetic agents such as 5-hydroxytryptamine-4 receptor agonists, intestinal secretagogues, and peripheralopioid antagonists could be effective in patients with constipation who cannot get adequate relief from current laxatives.Biofeedback could relieve symptoms in selected patients with constipation due to pelvic floor dyssynergia. Surgical treatments canbe helpful in some patients with refractory constipation.

Keywords

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