喝酸奶吃粗粮服泻药,对付便秘须分清功能性还是器质性

2017-05-04 尹路/上海同济大学附属第十人民医院腹部外科疑难诊治中心主任、主任医师 澎湃新闻

经历了春季最后一个节气“谷雨”,天气一天天热起来。伴随环境温度的上升,一些人身体的“内热”也开始升腾,随之而来的便是便秘等困扰。关于如何解决“出口拥堵”问题,坊间流传着各种“验方”——饮酸奶、喝蜂蜜水、食植物油、吃粗纤维食物、做腹部运动、服泻药……凡此种种,不一而足。而在专科医师看来,并没有一种方法能适用于所有类型的便秘患者,只有在明确诊断的基础上对症施策,才能收到令人满意的疗效。严格说来,便秘并

经历了春季最后一个节气“谷雨”,天气一天天热起来。伴随环境温度的上升,一些人身体的“内热”也开始升腾,随之而来的便是便秘等困扰。

关于如何解决“出口拥堵”问题,坊间流传着各种“验方”——饮酸奶、喝蜂蜜水、食植物油、吃粗纤维食物、做腹部运动、服泻药……凡此种种,不一而足。而在专科医师看来,并没有一种方法能适用于所有类型的便秘患者,只有在明确诊断的基础上对症施策,才能收到令人满意的疗效。

严格说来,便秘并不是一种独立的疾病,而是并发于多种疾病(主要是消化道疾病)的综合性症状,患者可有排便次数减少、粪便量减少、粪便干结、排便费力等表现。虽然便秘短时间内不致严重影响健康,但它给生活质量带来的损害却是显而易见的。

从病理基础角度来看,便秘分为功能性与器质性两大类。前者如肠管病变(炎症、肿瘤、压迫等引起的狭窄)、直肠肛门病变、内分泌代谢疾病(糖尿病神经病变、甲状腺功能低下等)、神经心理障碍、药物性因素等,后者如进食过少、饮水不足、精神紧张焦虑、生活环境改变等。

如果是功能性便秘,可先予以日常饮食的调整——适当减少膳食中动物性食物(特别是精加工的火腿、香肠以及腌制、熏烤的肉类)的比例,增加新鲜蔬菜(特别是叶菜类、薯类)、水果(特别是果胶含量较高的苹果、香蕉、芒果等)、益生菌类食物(如酸奶、奶酪等)的比例。

在饮食结构改变的基础上,注意加强运动、保持正常作息避免劳累与熬夜。通过一段时间的调整,相当一部分患者的便秘症状可得到缓解与改善。若收效甚微,可考虑在医生指导下使用益生菌、膳食纤维制剂,或适当使用具有润肠、泻下作用的药物,但用药的种类和周期应严格遵医嘱。

若明确诊断是器质性病变,则应针对病因予以治疗,如甲状腺功能减退患者积极治疗甲减,糖尿病并发神经病变患者将血糖控制在理想水平,结肠或直肠病变患者需要外科手术矫正者及时手术。

需要特别指出的是,有少部分患者的病情是由消化道肿瘤引起的,所以不可对便秘症状听之任之,应及时诊治。

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    2017-05-13 七堇

    便秘腹泻都是胃肠道有问题。及时纠正调整,方法对头,就没有问题吧!

    0

  3. 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    2017-05-09 虈亣靌

    深刻研究其中的含义

    0

  4. 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likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Fri May 05 10:11:30 CST 2017, time=2017-05-05, status=1, ipAttribution=)]
    2017-05-09 flysky120

    学习一下知识

    0

  5. 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    2017-05-08 ylzr123

    好文,值得点赞,更值得收藏!慢慢领会学习的。给点个赞!

    0

  6. 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    2017-05-07 自认为还有良知的医生

    以为有什么新套路

    0

  7. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3ywTqWUXPMtV5GE17mG4e4NneoTGY3OVj0y1bqCerSR142iayaqgUK6jU1nVxD23AyNSHWAsic7RTGg/0, createdBy=ea001978292, createdName=自认为还有良知的医生, createdTime=Sun May 07 12:15:02 CST 2017, time=2017-05-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194561, encodeId=d4a31945610f, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat May 06 11:42:18 CST 2017, time=2017-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1489397, encodeId=c487148939e18, content=<a href='/topic/show?id=6647650e22d' target=_blank style='color:#2F92EE;'>#泻药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=65072, encryptionId=6647650e22d, topicName=泻药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ddee8545068, createdName=xuqianhua, createdTime=Sat May 06 11:21:00 CST 2017, time=2017-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194253, encodeId=349a19425314, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K55C9kxQXN5fgJBehMO2KJ5ZpCYdAPibibuwkn1D6oNSicgwtWhcZD6bhCoMQ55NK3QMJCbiawCibxEIg/0, createdBy=d9902032842, createdName=155无悔, createdTime=Fri May 05 20:19:34 CST 2017, time=2017-05-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=194093, encodeId=05d2194093d4, content=学习了谢谢了。-, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Fri May 05 10:11:30 CST 2017, time=2017-05-05, status=1, ipAttribution=)]
    2017-05-06 往日如昨

    学习了谢谢分享

    0

  8. 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likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Fri May 05 10:11:30 CST 2017, time=2017-05-05, status=1, ipAttribution=)]
    2017-05-06 xuqianhua
  9. 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likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Fri May 05 10:11:30 CST 2017, time=2017-05-05, status=1, ipAttribution=)]
    2017-05-05 155无悔

    学习了,谢谢

    0

  10. 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    2017-05-05 186****0580(小山羊)

    学习了谢谢了。-

    0

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