药物治疗对改善便秘的症状是相当有效的。[117]American College of Gastroenterology Chronic Constipation Task Force. An evidence-based approach to the management of chronic constipation in North America. Am J Gastroenterol. 2005;100 Suppl 1:S1-4.http://www.ncbi.nlm.nih.gov/pubmed/16008640?tool=bestpractice.com 在设计良好的随机对照试验中，药物治疗和安慰剂对比显示具有10%至30%的治疗增益。[72]Barish CF, Drossman D, Johanson JF, et al. Efficacy and safety of lubiprostone in patients with chronic constipation. Dig Dis Sci. 2010 Apr;55(4):1090-7.http://www.ncbi.nlm.nih.gov/pubmed/20012484?tool=bestpractice.com[85]Müller-Lissner S, Rykx A, Kerstens R, et al. A double-blind, placebo-controlled study of prucalopride in elderly patients with chronic constipation. Neurogastroenterol Motil. 2010 Sep;22(9):991-8.http://www.ncbi.nlm.nih.gov/pubmed/20529205?tool=bestpractice.com[86]Quigley EM, Vandeplassche L, Kerstens R, et al. 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 Feb 1;29(3):315-28.http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2008.03884.x/fullhttp://www.ncbi.nlm.nih.gov/pubmed/19035970?tool=bestpractice.com[116]Mueller-Lissner S, Kamm MA, Wald A, et al. Multicenter, 4-week, double-blind, randomized, placebo-controlled trial of sodium picosulfate in patients with chronic constipation. Am J Gastroenterol. 2010;105:897-903.http://www.ncbi.nlm.nih.gov/pubmed/20179697?tool=bestpractice.com[118]Lembo AJ, Kurtz CB, Macdougall JE, et al. Efficacy of linaclotide for patients with chronic constipation. Gastroenterology. 2010;138:886-895.http://www.ncbi.nlm.nih.gov/pubmed/20045700?tool=bestpractice.com 对于排便功能障碍的患者生物反馈治疗的有效率为60%-80%。[88]Chiarioni G, Whitehead WE, Pezza V, et al. Biofeedback is superior to laxatives for normal transit constipation due to pelvic floor dyssynergia. Gastroenterology. 2006 Mar;130(3):657-64.http://www.ncbi.nlm.nih.gov/pubmed/16530506?tool=bestpractice.com[89]Rao SS, Seaton K, Miller M, et al. Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation. Clin Gastroenterol Hepatol. 2007 Mar;5(3):331-8.http://www.ncbi.nlm.nih.gov/pubmed/17368232?tool=bestpractice.com[91]Heymen S, Wexner SD, Vickers D, et al. Prospective, randomized trial comparing for biofeedback techniques for patients with constipation. Dis Colon Rectum. 1999 Nov;42(11):1388-93.http://www.ncbi.nlm.nih.gov/pubmed/10566525?tool=bestpractice.com[119]Enck P, Van der Voort IR, Klosterhalfen S. Biofeedback therapy in fecal incontinence and constipation. Neurogastroenterol Motil. 2009;21:1133-1141.http://www.ncbi.nlm.nih.gov/pubmed/19566591?tool=bestpractice.com 同样的，手术可以改善约50%至65%的难治性便秘患者的症状。[93]Lees NP, Hodson P, Hill J, et al. Long-term results of the antegrade continent enema procedure for constipation in adults. Colorectal Dis. 2004 Sep;6(5):362-8.http://www.ncbi.nlm.nih.gov/pubmed/15335371?tool=bestpractice.com[94]Pemberton JH, Rath DM, Ilstrup DM. Evaluation and surgical treatment of severe chronic constipation. Ann Surg. 1991 Oct;214(4):403-11.http://www.ncbi.nlm.nih.gov/pubmed/1953096?tool=bestpractice.com[120]Nyam DC, Pemberton JH, Ilstrup DM, et al. Long-term results of surgery for chronic constipation. Dis Colon Rectum. 1997;40:273-279.http://www.ncbi.nlm.nih.gov/pubmed/9118740?tool=bestpractice.com
