gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2017-27-3-75-83gastro-j-160Research ArticleКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИCLINICAL GUIDELINESКлинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению взрослых пациентов с хроническим запоромDiagnostics and treatment of chronic constipation in adults: clinical guidelines of the Russian gastroenterological associationИвашкинВ. Т.IvashkinV. T.noemail@neicon.ruМаевИ. В.MayevI. V.noemail@neicon.ruШептулинА. А.SheptulinA. A.arkalshep@gmail.comТрухмановА. С.TrukhmanovA. S.noemail@neicon.ruПолуэктоваЕ. А.PoluektovaYe. A.noemail@neicon.ruБаранскаяЕ. К.BaranskayaYe. K.noemail@neicon.ruШифринО. С.ShifrinO. S.noemail@neicon.ruЛапинаТ. Л.LapinaT. L.noemail@neicon.ruОсипенкоМ. Ф.OsipenkoM. F.noemail@neicon.ruСиманенковВ. И.SimanenkovV. I.noemail@neicon.ruХлыновИ. Б.KhlynovI. B.noemail@neicon.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова»РоссияFederal State Autonomous Educational Institution of Higher Education «I.M. Sechenov First Moscow State Medical University»Russian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова»РоссияState educational government-financed institution of higher professional education «Yevdokimov Moscow State University of Medicine and Dentistry»Russian FederationФГБОУ ВПО «Северо-Западный государственный медицинский университет им. И. И. Мечникова»РоссияState educational government-financed institution of higher professional education «Mechnikov North-Western State Medical university»Russian FederationФГБОУ ВПО «Новосибирский государственный медицинский университет»РоссияState educational government-financed institution of higher professional education «Novosibirsk state medical university»Russian FederationФГБОУ ВПО «Уральский государственный медицинский университет»РоссияState educational government-financed institution of higher professional education «Ural state medical university»Russian Federation2017120820182737583Copyright © Ивашкин В.Т., Маев И.В., Шептулин А.А., Трухманов А.С., Полуэктова Е.А., Баранская Е.К., Шифрин О.С., Лапина Т.Л., Осипенко М.Ф., Симаненков В.И., Хлынов И.Б., 20182018Ивашкин В.Т., Маев И.В., Шептулин А.А., Трухманов А.С., Полуэктова Е.А., Баранская Е.К., Шифрин О.С., Лапина Т.Л., Осипенко М.Ф., Симаненков В.И., Хлынов И.Б.Ivashkin V.T., Mayev I.V., Sheptulin A.A., Trukhmanov A.S., Poluektova Y.A., Baranskaya Y.K., Shifrin O.S., Lapina T.L., Osipenko M.F., Simanenkov V.I., Khlynov I.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/160

Цель публикации. Познакомить практикующих врачей с современными представлениями об этиологии и патогенезе запора, его классификацией, а также основными методами диагностики и лечения. Основные положения. Распространенность запора в популяции высока - в среднем 12-19%. Различают первичный (функциональный) и вторичный запор, причинами возникновения которого служат механические препятствия для пассажа содержимого по кишечнику, неврологические и эндокринные заболевания, системные заболевания соединительной ткани, прием лекарственных препаратов и др. При постановке диагноза функционального запора важно своевременное выявление «симптомов тревоги», наличие которых предполагает тщательное обследование больных. Кроме того, поэтапную инструментальную диагностику проводят при недостаточной эффективности терапии. Лечение запора должно быть комплексным и включать общие мероприятия (повышение физической активности, увеличение содержания пищевых волокон в рационе питания и др.), прием псиллиума, слабительных препаратов, в первую очередь полиэтиленгликоля, а при их недостаточной эффективности - энтерокинетиков. Заключение. Успешное лечение запора предполагает правильное определение его причины, соблюдение необходимых диетических рекомендаций и ступенчатое применение лекарственных препаратов.

Aim of publication. To present the modern concept on etiology and pathogenesis of constipation, its classification, basic diagnostic and treatment methods to general practitioners. Summary. The prevalence of constipation in general population is quite high and averages 12 to 19%. Two types of constipation are usually distinguished: primary (functional) and secondary that is related to mechanical obstruction of the intestinal passage of bowel content, neurologic and endocrine diseases, systemic diseases of connective tissue, intake of drugs etc. At diagnosing of functional constipation early detection of «alarm symptoms» which require thorough patient investigation is important. Moreover, insufficient treatment response require step-by-step instrumental diagnostics. Constipation treatment has to be comprehensive and include general recommendations (intensification of physical activity, increase in dietary fiber in daily ration etc.), intake of psyllium, laxatives, including first of all of polyethyleneglycol, at insufficient response enterokinetic agents. Conclusion. Successful treatment of constipation requires correct detection of its cause, following essential dietary recommendations and stepwise application of pharmaceutical agents.

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