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Forstoppelse hos voksne

Sist revidert:
Sist revidert av:
Definisjon:
Defineres som avføring to eller færre ganger pr uke, unormalt mye trykking for å få tømt seg, hard og knollete avføring eller følelse av ufullstendig tømning
Forekomst:
Forekommer hos opptil 20% av befolkningen og er et stort problem blant eldre. Ca. 10% bruker avføringsmiddel
Symptomer:
Dersom slike symptomer ledsages av magesmerter, klassifiseres tilstanden som irritabel tarm av obstipasjonstype, om det ikke foreligger tegn til organisk sykdom
Funn:
Mulige funn kan være oppfylninger i abdomen, hemoroider, og avføring i rektum ved rektal eksplorasjon
Diagnostikk:
Aktuelle prøver i forhold til blod på hanske eller i avføringen, orienterende biokjemiske prøver og ev. rektoskopi
Behandling:
Foreskjellige avføringsmidler kan benyttes. Forebyggende tiltak er viktige

 

  1. Mounsey A, Raleigh M, Wilson A. Management of constipation in older adults. Am Fam Physician. 2015 Sep 15;92(6):500-504.
  2. Aziz I, Whitehead WE, Palsson OS, et al. An approach to the diagnosis and management of Rome IV functional disorders of chronic constipation. Expert Rev Gastroenterol Hepatol. 2020;14(1):39-46. PubMed  
  3. Jamshed N, Lee Z-E. Diagnostic approach to chronic constipation in adults. Am Fam Physician 2011; 84: 299-306. American Family Physician  
  4. Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol. 2011 Sep;106(9):1582-91. PubMed  
  5. Peppas G, Alexiou VG, Mourtzoukou E, et al. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol. 2008 Feb 12;8:5. PubMed  
  6. Rao S, Sharma A. Constipation. BMJ Best Practice, last reviewed 22 Nov 2021. bestpractice.bmj.com  
  7. Bharucha AE, Wald A. Chronic Constipation. Mayo Clin Proc. 2019;94(11):2340-2357. PubMed  
  8. Ternent CA, Bastawrous AL, Morin NA, et al.; Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the evaluation and management of constipation. Dis Colon Rectum 2007; 50: 2013-22. PubMed  
  9. De Schryver AM, Keulemans YC, Peters HP, et al. Effects of regular physical activity on defecation pattern in middle-aged patients complaining of chronic constipation. Scand J Gastroenterol 2005; 40: 422-9. PubMed  
  10. Liu Z, Yan S, Wu J, et al. Acupuncture for chronic severe functional constipation. Ann Intern Med 2016; 165: 761-9. pmid:27618593 PubMed  
  11. Rao SSC, Brenner DM Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. Am J Gastroenterol. 2021. PMID: 33767108 PubMed  
  12. Lever E, Cole J, Scott SM, et al. Systematic review: the effect of prunes on gastrointestinal function. Aliment Pharmacol Ther 2014; 40: 750-8. doi:10.1111/apt.12913 DOI  
  13. Abbott R, Ayres I, Hui E, Hui K-K. Effect of perineal self-acupressure on constipation: A randomized controlled trial. J Gen Intern Med 2015; 30:434. DOI: 10.1007/s11606-014-3084-6 DOI  
  14. Paré P, Fedorak RN. Systematic review of stimulant and nonstimulant laxatives for the treatment of functional constipation. Can J Gastroenterol Hepatol 2014; 28: 549-57. pmid:25390617 PubMed  
  15. Lee-Robichaud H, Thomas K, Morgan J, Nelson RL. Lactulose versus Polyethylene Glycol for Chronic Constipation. Cochrane Database Syst Rev 2010; (7): CD007570. doi:10.1002/14651858.CD007570.pub2 PMID: 20614462 PubMed  
  16. Ramkumar D , et al. Efficacy and safety of traditional medical therapies for chronic constipation: systematic review. Am J Gastroenterol 2005; 100: 936-71. PubMed  
  17. Katelaris P, Naganathan V, Liu K, et al. Comparison of the effectiveness of polyethylene glycol with and without electrolytes in constipation: a systematic review and network meta-analysis. BMC Gastroenterol. 2016 Mar 31;16:42. pmid:27029340 PubMed  
  18. DiPalma JA, Cleveland MV, McGowan J, Herrera JL. A randomized, multicenter placebo-controlled trial of polyethylene glycol laxative for chronic treatment of chronic constipation. Am J Gastroenterol 2007; 102: 1436-41. PubMed  
  19. Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG. Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane Database of Systematic Reviews 2016, Issue 8. Art. No.: CD009118. DOI: 10.1002/14651858.CD009118.pub3. DOI  
  20. Schoenfeld P, Lacy BE, Chey WD, et al. Low-Dose Linaclotide (72 mug) for Chronic Idiopathic Constipation: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial. Am J Gastroenterol. 2017. PMID: 29091082 PubMed  
  21. FDFA News release. FDAapproves Trulance for Chronic idiopathic constipation. FDA Jan. 2017. www.fda.gov  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Jan H. Dybdahl, overlege, Medisinsk avdeling, Regionsykehuset i Trondheim
  • Hermod Petersen, professor og overlege, Norges teknisk-naturvitenskapelige universitet og Medisinsk avdeling, Regionsykehuset i Trondheim