medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2013-1-2-98-100medsovet-848Research ArticleПрактикаPracticeСовременная терапия хронических запоровModern management of chronic constipationПарфеновА. И.ParfyonovA. I.noemail@neicon.ruЦНИИГРоссияthe Central Scientific Research Institute for Gastroenterology, MoscowRussian Federation20133012201301-298100Copyright © Парфенов А.И., 20132013Парфенов А.И.Parfyonov A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/848

Хронический запор (ХЗ) — одно из распространенных нарушений функции кишечника, в среднем встречается у 15% населения и у большинства лиц пожилого и старческого возраста. Проблему для диагностики и лечения составляют функциональные запоры (ФЗ). В патогенезе ФЗ ведущую роль играет дискинезия (синдром раздраженного кишечника с преобладанием запоров), гипокинезия (инертная толстая кишка) и диссинергия мышц тазового дна (диссинергическая дефекация). Эффективность лечения ХЗ зависит от установления этиологии запоров, инструментальной оценки моторной функции кишечника и мышц тазового дна. Римские критерии III 2006 г. позволяют уверенно поставить диагноз ФЗ и синдрома раздраженного кишечника с запорами (СРК-З) и провести лечение регуляторами моторики. Пациентам с инертной толстой кишкой показаны энтерокинетики. Эти препараты ускоряют толстокишечный транзит, улучшают консистенцию стула и уменьшают напряжение при дефекации. Больные с диссинергической дефекацией должны получать биофидбектерапию (БФБТ).

Chronic constipation (CC) is one of the most common disorders of bowel function occurring on average in 15% of population and in the majority of elderly and senile age people. Functional constipations (FC) are a challenge for diagnosis and treatment. Dyskinesia (irritable bowel syndrome with constipation predominance), hypokinesia (inert colon) and pelvic floor dyssynergia (defecation dyssynergia) are major factors of FL. The effectiveness of treatment depends on defining the etiology of constipation, instrumental evaluation of motor function of intestine and pelvic floor muscles. Rome III criteria 2006 help to make a well-based diagnosis of FL and irritable bowel syndrome with constipation (IBS-C). Motor regulators are prescribed for the treatment of the disorder. Patients with inert colon are recommended to take enterokinetics. These drugs accelerate colonic transit, improve stool consistency and reduce straining. Patients with bowel dyssynergic defecation should take biofeedback therapy (BFT).

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The authors declare that there are no conflicts of interest present.