便秘

Constipation refers to bowel movements that are infrequent or hard to pass.[2] The stool is often hard and dry. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements is between three per day and three per week.[3]

便秘係指因糞便會太硬或是太乾而排便不順或難以排出[2],正常排便的頻率約在每日三次到每週三次之間[3],便秘的併發症包含痔瘡、肛裂、糞便阻塞。

Constipation has many causes. Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic disorders. Underlying associated diseases include hypothyroidism, diabetes, Parkinson’s disease, colon cancer, diverticulitis, and inflammatory bowel disease.[3][4] Medications associated with constipation include opioids, certain antacids, calcium channel blockers, and anticholinergics.[3] Of those taking opioids about 90% develop constipation.[5] Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person’s family, or it is of new onset in someone who is older.[6]

便秘通常有許多成因,常見原因包含內有糞便的結腸運動得很慢、患有腸躁症或骨腔疾病等,相關的潛在性疾病包含甲狀腺功能減退症、腹瀉、帕金森氏症、結腸癌、憩室炎、炎症性腸病[3][4] 等,導致便秘的藥物治療包含服用鴉片類藥物、特定抗酸藥、鈣通道阻滯劑以及抗膽鹼劑[3] ,大約90%服用鴉片藥物的患者會發生便秘[5]。當便秘患者發生下述情況時將需要進一步的觀察,如便秘體重減輕、貧血、糞便帶血,家族病史中有人擁有炎症性腸病或結腸癌者,或初發時患者年事已高等。[6]

Treatment of constipation depends on the underlying cause and the duration that it has been present. Measures that may help include drinking enough fluids, eating more fiber, and exercise. If this is not effective laxatives of the bulk forming agent, osmotic agent, stool softener, or lubricant type may be recommended. Stimulant laxatives are generally reserved for when other types are not effective. Other treatments may include biofeedback or surgery.[3]

便秘的治療方式依其潛在性成因和患病時間長度有所不同,可能有幫助的措施包含飲用足夠的液體,攝取多一點纖維及增進運動等,如果上述方法都無效,建議服用膨脹型瀉劑的瀉藥、滲透劑、軟便劑或潤滑劑;刺激型瀉藥僅建議給上述方式都無效的患者,其他療法包含生物回饋或接受手術。[3]

In the general population rates of constipation are 2–30 percent.[7] Among old people living in a care home the rate of constipation is 50–75 percent.[5] People spend, in the United States, more than US$250 million on medications for constipation a year.[8]

通常便秘的發生率約在 2-30%[7],生活於安養院的老人則提高到50-70%[5];在美國,平均一年投入2.5億美元在便秘治療上。[8]