Functional disorders of defecation: evaluation and treatment.
Functional disorders of defecation: evaluation and treatment.
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DOI：
10.1007/s11938-007-0015-1
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发表时间：
2007-06-01
期刊：
影响因子：
--
通讯作者：
Rao, Satish S C
中科院分区：
文献类型：
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作者：
Feyen, Bryan J;Rao, Satish S C
排便功能障碍是常见的，往往与慢传输型便秘重叠。它们包括功能性梗阻性疾病，如排便不协调，以及结构性梗阻性疾病，如直肠脱垂，会阴过度下降和直肠前突。评估包括详细的病史、直肠和盆腔检查以及生理检查，如肛门直肠测压、球囊排出试验、排粪造影和MRI。治疗涉及几种医学，行为和手术方法。最近，随机对照试验表明，生物反馈疗法是一种有效的治疗排便协同失调。吻合器经肛门直肠切除术似乎是治疗直肠前突、会阴过度下降和粘膜套叠相关排便障碍的一种有前途的技术，但缺乏对照试验。
Functional disorders of defecation are common and often overlap with slow-transit constipation. They are comprised of functional obstructive conditions such as dyssynergic defecation, as well as structural obstructive conditions such as rectal prolapse, excessive perineal descent, and rectocele. Evaluation includes detailed history and rectal and pelvic exam together with physiologic tests such as anorectal manometry, balloon expulsion test, defecography, and MRI. Treatment involves several medical, behavioral, and surgical approaches. Recently, randomized controlled trials have shown that biofeedback therapy is an effective treatment for dyssynergic defecation. Stapled transanal rectal resection appears to be a promising technique for treating defecation disorders associated with rectocele, excessive perineal descent, and mucosal intussusception, but controlled trials are lacking.