怎样治疗便秘最有效

如何治疗便秘最有效配图，仅供参考

Constipation
When treating mild to moderate symptoms of constipation-predominant IBS,dietary and lifestyle modifications should be the initial management tools. Patients should increase their consumption of fiber-enriched foods,and the physician needs to encourage fluid intake to prevent stool dehydration. Teaching the patient to schedule times for bowel evacuations with the aid of stimulating substances such as coffee or prunes allows for a regimental routine,thus eliminating previously unrecognizable bad habits. Bulking agents (corn fiber,bran,psyllium,polycarbophil,ispaghula husk,and methylcellulose) are a simple and inexpensive next-treatment option. In theory,adding these to the diet increases luminal water,which adds bulk to the stool and allows easier stool passage. One meta-analysis of 13 trials using bulking agents concluded that evidence was lacking to firmly demonstrate an advantage with only polycarbophil and ispaghula husk in three trials exhibiting improvement in constipation. Not surprisingly,no benefit was seen with abdominal pain or bloating. Furthermore,a systematic review summarized that all 13 trials were flawed in methodology and fiber was no more effective than placebo. A randomized placebo controlled trial compared the effectiveness of increasing dietary content of soluble fiber (psyllium) or insoluble fiber (bran) in patients with IBS. It was concluded that those patients taking psyllium had a significant improvement in relief of symptoms and overall reduction in severity of symptoms. However,bran showed no clinical benefit and actually caused worsening of symptoms in many cases. Given that these agents possess a relatively safe profile,it is reasonable to prescribe a trial as initial management for constipation with the understanding that these agents can worsen bloating and abdominal discomfort. Currently,there are no randomized controlled trials examining laxatives in IBS patients. However,polyethylene glycol can be considered for refractory cases as it was shown to improve stool frequency but not abdominal pain.
Lubiprostone is a locally acting chloride channel activator that enhances chloride-rich intestinal fluid secretion. It was initially approved for use in chronic idiopathic constipation,but later received approval for use in women with constipation-predominant IBS. Two placebo-controlled trials as well as an open-label study showed significant overall response to the medication. The approved dose for IBS is 8 μg twice daily,and 24 μg dosing can be used for constipation. There seem to be no short-term safety issues and the main side effect is nausea. However,long-term safety remains to be established. Further studies will need to be performed to determine its role in treatment of male IBS patients. Currently,it is best reserved for women with IBS and severe constipation that has been refractory to other treatments.","department":"