Advertisement

Huisarts en wetenschap

, Volume 53, Issue 9, pp 484–498 | Cite as

NHG-Standaard Obstipatie

  • JM Diemel
  • APJM Van den Hurk
  • JWM Muris
  • MAM Pijpers
  • AAA Verheij
NHG-standaard

Samenvatting

De NHG-Standaarden geven richtlijnen voor het handelen van de huisarts; de rol van de huisarts staat dan ook centraal. Daarbij geldt echter altijd dat factoren van de kant van de patiënt het beleid mede bepalen. Om praktische redenen komt dit uitgangspunt niet telkens opnieuw in de richtlijn aan de orde, maar wordt het hier expliciet vermeld. De huisarts stelt waar mogelijk het beleid vast in samenspraak met de patiënt, met inachtneming van diens specifieke omstandigheden en met erkenning van diens eigen verantwoordelijkheid, waarbij adequate voorlichting een voorwaarde is.

NHG-Standaard obstipatie 

Literatuur

  1. Bij verwijzingen naar NHG-producten: zie https://doi.org/www.nhg.org.
  2. Arroyo A, Gonzalez-Argente FX, Garcia-Domingo M, Espin-Basany E, De-la-Portilla F, Perez-Vicente F et al. Prospective multicentre clinical trial of stapled transanal rectal resection for obstructive defaecation syndrome. Br J Surg 2008;95:1521-7.CrossRefGoogle Scholar
  3. Ashraf W, Park F, Lof J, Quigley EM. Effects of psyllium therapy on stool characteristics, colon transit and anorectal function in chronic idiopathic constipation. Aliment Pharmacol Ther 1995;9:639-47.CrossRefGoogle Scholar
  4. Attar A, Lemann M, Ferguson A, Halphen M, Boutron MC, Flourie B et al. Comparison of a low dose polyethylene glycol electrolyte solution with lactulose for treatment of chronic constipation. Gut 1999;44:226-30.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Banaszkiewicz A, Szajewska H. Ineffectiveness of Lactobacillus GG as an adjunct to lactulose for the treatment of constipation in children: a double-blind, placebo-controlled randomized trial. J Pediatr 2005;146:364-9.CrossRefGoogle Scholar
  6. Barr RG, Levine MD, Wilkinson RH, Mulvihill D. Chronic and occult stool retention: a clinical tool for its evaluation in school-aged children. Clin Pediatr (Phila) 1979;18:674, 676, 677-4,9, passim.Google Scholar
  7. Bass P, Dennis S. The laxative effects of lactulose in normal and constipated subjects. J Clin Gastroenterol 1981;3 Suppl 1:23-8.CrossRefGoogle Scholar
  8. Bassotti G, De Roberto G, Sediari L, Morelli A. Colonic motility studies in severe chronic constipation: an organic approach to a functional problem. Tech Coloproctol 2004;8:147-50.CrossRefGoogle Scholar
  9. Beck JJ, Elzevier HW, Pelger RC, Putter H, Voorham-van der Zalm PJ. Multiple pelvic floor complaints are correlated with sexual abuse history. J Sex Med 2009;6:193-8.CrossRefGoogle Scholar
  10. Beckmann KR, Hennes H, Sty JR, Walsh-Kelly CM. Accuracy of clinical variables in the identification of radiographically proven constipation in children. WMJ 2001;100:33-6.PubMedGoogle Scholar
  11. Benninga MA, Buller HA, Staalman CR, Gubler FM, Bossuyt PM, van der Plas RN et al. Defaecation disorders in children, colonic transit time versus the Barr-score. Eur J Pediatr 1995;154:277-84.CrossRefGoogle Scholar
  12. Berger M. Probiotica voor gastro-intestinale aandoeningen: het nieuwe wondermiddel? Huisarts Wet 2008;51:174-9.CrossRefGoogle Scholar
  13. Bharucha AE, Wald A, Enck P, Rao S. Functional anorectal disorders. Gastroenterology 2006;130:1510-8.CrossRefGoogle Scholar
  14. Bi L, Triadafilopoulos G. Exercise and gastro-intestinal function and disease: an evidence-based review of risks and benefits. Clin Gastroenterol Hepatol 2003;1:345-55.CrossRefGoogle Scholar
  15. Bongers ME, Van den Berg MM, Reitsma JB, Voskuijl WP, Benninga MA. A randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation. Clin Gastroenterol Hepatol 2009;7:1069-74.CrossRefGoogle Scholar
  16. Bouhnik Y, Neut C, Raskine L, Michel C, Riottot M, Andrieux C et al. Prospective, randomized, parallel-group trial to evaluate the effects of lactulose and polyethylene glycol-4000 on colonic flora in chronic idiopathic constipation. Aliment Pharmacol Ther 2004;19:889-99.CrossRefGoogle Scholar
  17. Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ. Systematic review on the management of chronic constipation in North America. Am J Gastroenterol 2005;100 Suppl 1:S5-S21.PubMedGoogle Scholar
  18. Brusciano L, Limongelli P, Pescatori M, Napolitano V, Gagliardi G, Maffettone V et al. Ultrasonographic patterns in patients with obstructed defaecation. Int J Colorectal Dis 2007;22:969-77.CrossRefGoogle Scholar
  19. Bu LN, Chang MH, Ni YH, Chen HL, Cheng CC. Lactobacillus casei rhamnosus Lcr35 in children with chronic constipation. Pediatr Int 2007;49:485-90.CrossRefGoogle Scholar
  20. Candy D, Belsey J. Macrogol (polyethylene glycol) laxatives in children with functional constipation and faecal impaction: a systematic review. Arch Dis Child 2009;94:156-60.CrossRefGoogle Scholar
  21. Cash BD, Lacy BE. Systematic Review: FDA-Approved Prescription Medications for Adults with Constipaton. Gastroenterology & Hepatology 2006;2:736-49.Google Scholar
  22. Chang JY, Locke GR, Schleck CD, Zinsmeister AR, Talley NJ. Risk factors for chronic constipation and a possible role of analgesics. Neurogastroenterol Motil 2007;19:905-11.CrossRefGoogle Scholar
  23. Commissie Farmaceutische Hulp van het College voor zorgverzekeringen. Farmacotherapeutisch Kompas. Diemen: College voor zorgverzekeringen, 2010. https://doi.org/www.fk.cvz.nl, geraadpleegd juni 2010.
  24. Corazziari E, Badiali D, Bazzocchi G, Bassotti G, Roselli P, Mastropaolo G et al. Long term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut 2000;46:522-6.CrossRefPubMedPubMedCentralGoogle Scholar
  25. De Lorijn F, Van Rijn RR, Heijmans J, Reitsma JB, Voskuijl WP, Henneman OD et al. The Leech method for diagnosing constipation: intra- and interobserver variability and accuracy. Pediatr Radiol 2006;36:43-9.CrossRefGoogle Scholar
  26. De Paula JA, Carmuega E, Weill R. Effect of the ingestion of a symbiotic yogurt on the bowel habits of women with functional constipation. Acta Gastroenterol Latinoam 2008;38:16-25.PubMedGoogle Scholar
  27. De Schryver AM, Keulemans YC, Peters HP, Akkermans LM, Smout AJ, De Vries WR 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.CrossRefGoogle Scholar
  28. DiPalma JA, Cleveland MB, McGowan J, Herrera JL. A comparison of polyethylene glycol laxative and placebo for relief of constipation from constipating medications. South Med J 2007a;100:1085-90.Google Scholar
  29. 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 2007b;102:1436-41.Google Scholar
  30. Fenn GC, Wilkinson PD, Lee CE, Akbar FA. A general practice study of the efficacy of Regulan in functional constipation. Br J Clin Pract 1986;40:192-7.PubMedGoogle Scholar
  31. Gill K. De defaecatie van de mens. Huisarts Wet 1979;22:186.Google Scholar
  32. Hamilton W, Lancashire R, Sharp D, Peters TJ, Cheng K, Marshall T. The risk of colorectal cancer with symptoms at different ages and between the sexes: a case-control study. BMC Med 2009;7:17.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Heineman MJ. Bekkenbodempathologie. Maarssen: Elsevier Gezondheidszorg, 2007.Google Scholar
  34. Hyman PE, Milla PJ, Benninga MA, Davidson GP, Fleisher DF, Taminiau J. Childhood functional gastro-intestinal disorders: neonate/toddler. Gastroenterology 2006;130:1519-26.CrossRefGoogle Scholar
  35. Joensson IM, Siggaard C, Rittig S, Hagstroem S, Djurhuus JC. Transabdominal ultrasound of rectum as a diagnostic tool in childhood constipation. J Urol 2008;179:1997-2002.CrossRefGoogle Scholar
  36. Kalso E, Edwards JE, Moore RA, McQuay HJ. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain 2004;112:372-80.CrossRefGoogle Scholar
  37. Kemper HCG, Ooijendijk WTM, Stiggelbout M. Consensus over de Nederlandse norm voor gezond bewegen. T Soc Geneesk 2000;78:180–183.Google Scholar
  38. Kienzle-Horn S, Vix JM, Schuijt C, Peil H, Jordan CC, Kamm MA. Efficacy and safety of bisacodyl in the acute treatment of constipation: a double-blind, randomized, placebo-controlled study. Aliment Pharmacol Ther 2006;23:1479-88.CrossRefPubMedPubMedCentralGoogle Scholar
  39. Koebnick C, Wagner I, Leitzmann P, Stern U, Zunft HJ. Probiotic beverage containing Lactobacillus casei Shirota improves gastro-intestinal symptoms in patients with chronic constipation. Can J Gastroenterol 2003;17:655-9.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Koh CE, Young CJ, Young JM, Solomon MJ. Systematic review of randomized controlled trials of the effectiveness of biofeedback for pelvic floor dysfunction. Br J Surg 2008;95:1079-87.CrossRefGoogle Scholar
  41. Kokke FT, Scholtens PA, Alles MS, Decates TS, Fiselier TJ, Tolboom JJ et al. A dietary fiber mixture versus lactulose in the treatment of childhood constipation: a double-blind randomized controlled trial. J Pediatr Gastroenterol Nutr 2008;47:592-7.CrossRefGoogle Scholar
  42. Kwaliteitsinstituut voor de Gezondheidszorg CBO. Richtlijn Obstipatie bij kinderen van 0 tot 18 jaar. Utrecht: Kwaliteitsinstituut voor de Gezondheidszorg CBO, 2009. https://doi.org/www.cbo.nl/thema/Richtlijnen/Overzicht-richtlijnen/Voedingsgerelateerde-aandoeningen/, geraadpleegd juni 2010.
  43. Leech SC, McHugh K, Sullivan PB. Evaluation of a method of assessing faecal loading on plain abdominal radiographs in children. Pediatr Radiol 1999;29:255-8.CrossRefGoogle Scholar
  44. Loening-Baucke V. Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics 1997;100:228-32.CrossRefGoogle Scholar
  45. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006;130:1480-91.PubMedGoogle Scholar
  46. Mathus-Vliegen EMH. Gastro-intestinale aandoeningen. In: Jansen PAF et al, redactie. Het geriatrie formularium: een praktische leidraad. 2e druk. Houten: Bohn Stafleu van Loghum, 2008.Google Scholar
  47. McCallum IJ, Ong S, Mercer-Jones M. Chronic constipation in adults. BMJ 2009;338:b831.CrossRefGoogle Scholar
  48. McNicol ED, Boyce D, Schumann R, Carr DB. Mu-opioid antagonists for opioid-induced bowel dysfunction. Cochrane Database Syst Rev 2008;CD006332.Google Scholar
  49. McRorie JW, Daggy BP, Morel JG, Diersing PS, Miner PB, Robinson M. Psyllium is superior to docusate sodium for treatment of chronic constipation. Aliment Pharmacol Ther 1998;12:491-7.CrossRefGoogle Scholar
  50. Mendoza J, Legido J, Rubio S, Gisbert JP. Systematic review: the adverse effects of sodium phosphate enema. Aliment Pharmacol Ther 2007;26:9-20.CrossRefGoogle Scholar
  51. Moore RA, McQuay HJ. Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. Arthritis Res Ther 2005;7:R1046-R1051.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Muris JW, Mathus-Vliegen EMH, Voorn ThB. Gastro-enterologie. 7e druk. Houten: Bohn Stafleu van Loghum, 2007.Google Scholar
  53. Muris JW, Starmans R, Wolf GG, Pop P, Knottnerus JA. The diagnostic value of rectal examination. Fam Pract 1993;10:34-7.CrossRefGoogle Scholar
  54. NIVEL/IQhealthcare/LINH. Spijsverteringsorganen: obstipatie. Incidentie- en prevalentiecijfers. In: Verheij RA, Van Dijk CE, Abrahamse H, Davids R, Van den Hoogen H, Braspenning J, Van Althuis T. Landelijk Informatienetwerk Huisartsenzorg. Feiten en cijfers over huisartsenzorg in Nederland. Utrecht/Nijmegen: NIVEL/IQ, 2009. https://doi.org/www.nivel.nl/oc2/page.asp?pageid=12694, geraadpleegd juli 2010.
  55. Pepin C, Ladabaum U. The yield of lower endoscopy in patients with constipation: survey of a university hospital, a public county hospital, and a Veterans Administration medical center. Gastrointest Endosc 2002;56:325-32.CrossRefGoogle Scholar
  56. Peppas G, Alexiou VG, Mourtzoukou E, Falagas ME. Epidemiology of constipation in Europe and Oceania: a systematic review. BMC Gastroenterol 2008;8:5.CrossRefPubMedPubMedCentralGoogle Scholar
  57. Perniola G, Shek C, Chong CC, Chew S, Cartmill J, Dietz HP. Defecation proctography and translabial ultrasound in the investigation of defecatory disorders. Ultrasound Obstet Gynecol 2008;31:567-71.CrossRefGoogle Scholar
  58. Petticrew M, Rodgers M, Booth A. Effectiveness of laxatives in adults. Qual Health Care 2001;10:268-73.CrossRefPubMedPubMedCentralGoogle Scholar
  59. Pijpers MA, Bongers ME, Benninga MA, Berger MY. Functional constipation in children: a systematic review on prognosis and predictive factors. J Pediatr Gastroenterol Nutr 2010;50:256-68.CrossRefGoogle Scholar
  60. Pijpers MA, Tabbers MM, Benninga MA, Berger MY. Currently recommended treatments of childhood constipation are not evidence based: a systematic literature review on the effect of laxative treatment and dietary measures. Arch Dis Child 2009;94:117-31.CrossRefGoogle Scholar
  61. Quigley EM, Vandeplassche L, Kerstens R, Ausma J. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation – A 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther 2009;29:315-28.CrossRefGoogle Scholar
  62. Rao SS, Ozturk R, Laine L. Clinical utility of diagnostic tests for constipation in adults: a systematic review. Am J Gastroenterol 2005;100:1605-15.CrossRefGoogle Scholar
  63. Rao SS, Tuteja AK, Vellema T, Kempf J, Stessman M. Dyssynergic defecation: demographics, symptoms, stool patterns, and quality of life. J Clin Gastroenterol 2004;38:680-5.CrossRefGoogle Scholar
  64. Rasquin A, Di Lorenzo C, Forbes D, Guiraldes E, Hyams JS, Staiano A et al. Childhood functional gastro-intestinal disorders: child/adolescent. Gastroenterology 2006;130:1527-37.CrossRefGoogle Scholar
  65. Reuchlin-Vroklage LM, Bierma-Zeinstra S, Benninga MA, Berger MY. Diagnostic value of abdominal radiography in constipated children: a systematic review. Arch Pediatr Adolesc Med 2005;159:671-8.CrossRefGoogle Scholar
  66. Rockney MD, McQuade WH, Days AL. The plain abonimal roentgenogram in the management of encopresis. Arch Pediatr Adolesc Med 1995;149:623-7.CrossRefGoogle Scholar
  67. Rouse M, Chapman N, Mahapatra M, Grillage M, Atkinson SN, Prescott P. An open, randomised, parallel group study of lactulose versus ispaghula in the treatment of chronic constipation in adults. Br J Clin Pract 1991;45:28-30.PubMedGoogle Scholar
  68. Sanders JF. Lactulose syrup assessed in a double-blind study of elderly constipated patients. J Am Geriatr Soc 1978;26:236-9.CrossRefGoogle Scholar
  69. Smith RG, Lewis S. The relationship between digital rectal examination and abdominal radiographs in elderly patients. Age Ageing 1990;19:142-3.CrossRefGoogle Scholar
  70. Smout AJPM, Brummer RJM. Gastro-intestinale chirurgie en gastro-enterologie. Ned Tijdschr Geneeskd 2000;144:878-84.PubMedGoogle Scholar
  71. Starreveld JS, Pols MA, Van Wijk HJ, Bogaard JW, Poen H, Smout AJ. The plain abdominal radiograph in the assessment of constipation. Z Gastroenterol 1990;28:335-8.PubMedGoogle Scholar
  72. Talley NJ, Jones M, Nuyts G, Dubois D. Risk factors for chronic constipation based on a general practice sample. Am J Gastroenterol 2003;98:1107-11.CrossRefGoogle Scholar
  73. Van den Berg M, Benninga MA, Di Lorenzo C. Epidemiology of childhood constipation: A systematic review. Am J Gastroenterol 2006;101:2401-9.CrossRefGoogle Scholar
  74. Van der Meer J, Stehouwer CDA. Interne geneeskunde. 13e druk. Houten: Bohn Stafleu van Loghum, 2005.Google Scholar
  75. Varma MG, Hart SL, Brown JS, Creasman JM, Van Den Eeden SK, Thom DH. Obstructive defecation in middle-aged women. Dig Dis Sci 2008;53:2702-9.CrossRefPubMedPubMedCentralGoogle Scholar
  76. Verheij RA, Van Dijk CE, Abrahamse H, Davids R,Van den Hoogen H, Braspenning J, Van Althuis T. Landelijk Informatienetwerk Huisartsenzorg. Feiten en cijfers over huisartsenzorg in Nederland. Utrecht/Nijmegen: NIVEL/IQ, 2009, https://doi.org/www.nivel.nl/oc2/page.asp?pageid=12694, geraadpleegd 3 juni 2010
  77. Voedingscentrum. Eten & Gezondheid [website]. Den Haag: Voedingscentrum, 2008. https://doi.org/www.voedingscentrum.nl/nl/eten-gezondheid/voedingstoffen/vezels.aspx, geraadpleegd juni 2010.
  78. Wald A. Constipation in the primary care setting: current concepts and misconceptions. Am J Med 2006;119:736-9.CrossRefGoogle Scholar
  79. Wesselius-De Casparis A, Braadbaart S, Bergh-Bohlken GE, Mimica M. Treatment of chronic constipation with lactulose syrup: results of a double-blind study. Gut 1968;9:84-6.Google Scholar
  80. Xing JH, Soffer EE. Adverse effects of laxatives. Dis Colon Rectum 2001;44:1201-9.CrossRefGoogle Scholar
  81. Yang YX, He M, Hu G, Wei J, Pages P, Yang XH et al. Effect of a fermented milk containing Bifidobacterium lactis DN-173010 on Chinese constipated women. World J Gastroenterol 2008;14:6237-43.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Bohn Stafleu van Loghum 2010

Authors and Affiliations

  • JM Diemel
    • 1
  • APJM Van den Hurk
  • JWM Muris
  • MAM Pijpers
  • AAA Verheij
  1. 1.

Personalised recommendations