臨牀消化器内科 Vol.13 No.13(10)


特集名 消化管治療薬の使い方 --その根拠と問題点
題名 便秘薬
発刊年月 1998年 12月
著者 岡田 光男 福岡大学医学部内科学第一
【 要旨 】 便秘は成因上,原因の明らかな器質性便秘と症候性便秘および原因不明の機能性便秘に大別される.便秘患者の大多数は機能性便秘であるが,便秘患者を診察する場合,原因の明らかな器質性および症候性便秘をきたす疾患を除外しておく必要がある.器質性便秘や症候性便秘ではその原因疾患の治療が便秘治療の基本となる.一方,機能性便秘の治療の基本は規則正しい朝食摂取と適度な運動よりなる生活指導,食物線維の増量を目的とした食事療法および薬物療法である.薬物療法では副作用が少なく,習慣性が乏しい膨張性下剤や塩類下剤を主として用い,刺激性下剤は習慣性があることより長期投与は控えるべきである.
Theme Direction of the Prescription for Gastrointestinal Tract
Title Medical Management of Constipation
Author Mitsuo Okada First Department of Internal Medicine, School of Medicine, Fukuoka University
[ Summary ] Constipation is divided into 3 categories on an etiological basis ; 1) constipation induced by mechanical obstruction, 2) constipation caused by various disorders (except gastrointestinal disease such as neurogenic disorders), endocrine disorders, myopathic disorders, metabolic disorders and drug induced constipation, caused by anticholinergics, opiate analgesics and so on, 3) idiopathic (functional) constipation. The treatment of constipation in the first and second cases ls based on the treatment of the underlying disorders. The treatment of functional constipation is based on an improvement in life style such as regular consumption of breakfast, proper exercise and dietary therapy, composed of a high-fiber diet, along with drug therapy. Laxatives, such as bulk agents and osmotic agents are used as the first line of treatment because of the low frequency of side effects. Irritant laxatives should not be used for extended periods because of their habit forming characteristics.
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