medicina60巻6号

2023年05月発行

特集 Common diseaseの処方箋ファイル—臨床経過から学ぶ20症例

CASE 6 便秘—便秘症状を訴える42歳女性

著者： 三原弘¹

所属機関： ¹札幌医科大学総合診療医学講座

ページ範囲：P.836 - P.841

42歳女性
現病歴　便秘症状を訴えて，予約外受診した．市販の下剤を内服しているが，効果がみられないという．大腸がん検診は毎年受診しており，今年も便潜血陰性であった．

参考文献

1）日本消化器病学会関連研究会　慢性便秘の診断・治療研究会：慢性便秘症診療ガイドライン2017，南江堂，2017

2）Curless R, et al：Comparison of gastrointestinal symptoms in colorectal carcinoma patients and community controls with respect to age. Gut 35：1267-1270, 1994

3）Gupta M, et al：Constipation is not associated with an increased rate of findings on colonoscopy；Results from a national endoscopy consortium. Endoscopy 42：208-212, 2010

4）日本消化器病学会：機能性消化管疾患診療ガイドライン2020—過敏性腸症候群（IBS）（改訂第2版），南江堂，2020

5）Halmos EP, et al：A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 146：67-75, 2014

6）Böhn L, et al：Diet low in FODMAPs reduces symptoms of irritable bowel syndrome as well as traditional dietary advice；A randomized controlled trial. Gastroenterology 149：1399-1407, 2015

7）Staudacher HM, et al：Comparison of symptom response following advice for a diet low in fermentable carbohydrates（FODMAPs）versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet 24：487-495, 2011

8）Black CJ, et al：Efficacy of a low FODMAP diet in irritable bowel syndrome；Systematic review and network meta-analysis. Gut 71：1117-1126, 2022

9）Kira I：Random control trial of hot compresses for women those who used laxatives on severity of constipation and quality of life. Jpn J Nurs Sci 13：95-104, 2016

10）Modi RM, et al：Implementation of a defecation posture modification device；Impact on bowel movement patterns in healthy subjects. J Clin Gastroenterol 53：216-219, 2019

11）Bijkerk CJ, et al：Systematic review；The role of different types of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 19：245-251, 2004

12）Rao SS, et al：ANMS-ESNM position paper and consensus guidelines on biofeedback therapy for anorectal disorders. Neurogastroenterol Motil 27：594-609, 2015

13）Fukudo S, et al：A randomized controlled and long-term linaclotide study of irritable bowel syndrome with constipation patients in Japan. Neurogastroenterol Motil 30：e13444, 2018

14）三原　弘：うんこのつまらない話，p37，中外医学社，2019

15）Johanson JF, et al：Clinical trial；Phase 2 study of lubiprostone for irritable bowel syndrome with constipation. Aliment Pharmacol Ther 27：685-696, 2008

16）Chapman RW, et al：Randomized clinical trial；Macrogol/PEG 3350 plus electrolytes for treatment of patients with constipation associated with irritable bowel syndrome. Am J Gastroenterol 108：1508-1515, 2013

17）Morishita D, et al：Senna versus magnesium oxide for the treatment of chronic constipation；A randomized, placebo-controlled trial. Am J Gastroenterol 116：152-161, 2011