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Запоры при беременности. Возможности терапии
Запоры при беременности. Возможности терапии
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Аннотация
Предпосылки: нормализация функции кишечника помогает снизить количество осложнений беременности.
Пациенты: под наблюдением в амбулаторных условиях находились 45 беременных: I триместр – 18 (40%), II – 17 (37,8%), III – 10 (22,2%), у которых, помимо осложнений беременности: угроза прерывания – 19 (42,2%), урогенитальная инфекция – 23 (51,1%), гестоз легкой степени – 3 (6,7%) – были жалобы на запор. Запор в анамнезе имели 16 (35,5%) пациенток. Всем был рекомендован Дюфалак® в дозе 20–25 мл ежедневно утром во время еды, длительность курса – 4 нед.
Результаты: положительный эффект (дефекация через 1–2 дня, нормальная консистенция стула, отсутствие побочных явлений) отмечен в 40 (88,9%) случаях, в 5 случаях эффект оказался недостаточным и дозу пришлось увеличить до 30–35 мл. Ни в одном случае не отмечено усугубления признаков угрозы прерывания беременности, бурной перистальтики кишечника, метеоризма, тошноты.
Заключение: при запорах на фоне беременности Дюфалак® – препарат выбора.
Ключевые слова: запор при беременности, Дюфалак.
Patients. 45 pregnant outpatients were followed up, including: 18 (40%) – in I trimester, 17 (37,8%) – in II , and 10 (22,2%) – in III who, apart from the following complications of pregnancy – threatening abortion – 19 (42,2%), urogenital infection – 23 (51,1%), mild preeclampsia – 3 (6,7%) also suffered from constipation. History of constipation was present in sixteen (35,5%) cases. All patients were administered DuphalacR in a daily dose of 20–25 ml, during breakfast, for the course of 4 weeks.
Results. Positive effect (defecation in 1–2 days, normal stool consistency, no side effects) were observed in 40 (88,9%) cases, while in 5 cases the effect was insufficient, and the dose had to be increased up to 30–35 ml. Administered therapy didn’t induce any aggravation of threatening abortion, or colonic hyperpropulsion, or bloating and nausea.
Conclusion. Dyufalak – is the drug of choice for threatment of constipation during pregnancy.
Key words: constipation in pregnancy, Duphalac.
Пациенты: под наблюдением в амбулаторных условиях находились 45 беременных: I триместр – 18 (40%), II – 17 (37,8%), III – 10 (22,2%), у которых, помимо осложнений беременности: угроза прерывания – 19 (42,2%), урогенитальная инфекция – 23 (51,1%), гестоз легкой степени – 3 (6,7%) – были жалобы на запор. Запор в анамнезе имели 16 (35,5%) пациенток. Всем был рекомендован Дюфалак® в дозе 20–25 мл ежедневно утром во время еды, длительность курса – 4 нед.
Результаты: положительный эффект (дефекация через 1–2 дня, нормальная консистенция стула, отсутствие побочных явлений) отмечен в 40 (88,9%) случаях, в 5 случаях эффект оказался недостаточным и дозу пришлось увеличить до 30–35 мл. Ни в одном случае не отмечено усугубления признаков угрозы прерывания беременности, бурной перистальтики кишечника, метеоризма, тошноты.
Заключение: при запорах на фоне беременности Дюфалак® – препарат выбора.
Ключевые слова: запор при беременности, Дюфалак.
________________________________________________
Patients. 45 pregnant outpatients were followed up, including: 18 (40%) – in I trimester, 17 (37,8%) – in II , and 10 (22,2%) – in III who, apart from the following complications of pregnancy – threatening abortion – 19 (42,2%), urogenital infection – 23 (51,1%), mild preeclampsia – 3 (6,7%) also suffered from constipation. History of constipation was present in sixteen (35,5%) cases. All patients were administered DuphalacR in a daily dose of 20–25 ml, during breakfast, for the course of 4 weeks.
Results. Positive effect (defecation in 1–2 days, normal stool consistency, no side effects) were observed in 40 (88,9%) cases, while in 5 cases the effect was insufficient, and the dose had to be increased up to 30–35 ml. Administered therapy didn’t induce any aggravation of threatening abortion, or colonic hyperpropulsion, or bloating and nausea.
Conclusion. Dyufalak – is the drug of choice for threatment of constipation during pregnancy.
Key words: constipation in pregnancy, Duphalac.
Полный текст
Список литературы
1. Агафонова Н.А., Гиоева И.З., Григорьева Ю.В. и др. Нарушение нормального состава кишечных бактерий: клиническое значение и вопросы терапии. Русский медицинский журнал, 2008; 10: 2.
2. Бурков С.Г. Запоры беременных: взгляд на проблему. РМЖ, 2006; 8: 1.
3. Буторова Л.И., Калинин А.В. Значение лактулозы в регуляции кишечной микрофлоры. Клинические перспективы гастроэнтерологии, гепатологии, 2002; 6:21–6.
4. El-Tawil AM. Is the DHEAS/cortisol ratio a potential filter for non-operable constipated cases? World J Gastroenterol 2010; 16 (6): 659–62.
5. Czeizel AE, Puhó EH, Bánhidy F. Sex ratio of newborn infants born to pregnant women with severe chronic constipation. Clin Epidemiol 2010; 2: 217–9.
6. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials: Probiotics for functional constipation. World J Gastroenterol 2010; 16 (1): 69–75.
7. Arnaud MJ. Mild dehydration: a risk factor of constipation. Eur J Clin Nutr 2003; 57: S88–S95.
8. Aserko HB, Benett J. Effekt of antibiotic therapy in acute salmonellosis on the faecal excretion of salmonellae. J Med 1969; H 636–400.
9. Bernhardt H, Knoke M. Mycological aspects of gastrointestinal microflora. J Gastroenterol 1997; 32 (Suppl. 222): 102–6.
10. Blaut M. Relationship of prebiotics and food to intestinal microflora. Eur J Nutr 2002; 41 (Suppl. 1): I11–6.
11. Bollongue J, Schumann С. Effect of Lactulose and Lactitol on Colonic Microflora and Enzymatic Activity. J Gastroenterol 1997; 32 (Suppl 222): 41–4.
12. Bonapace ES, Fisher RS. Constipation and diarrhea in pregnancy. Gastroenterology Clinics of North America 1998; 27: 197–211.
13. Bradley CS, Kennedy CM, Turcea AM et al. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110 (6): 1351–7.
14. Christofides ND, Ghatei MA, Bloom SR et al. Decreased plasma motilin concentrations in pregnancy. British Medical Journal 1982; 285: 1453–4.
15. Kien CL, Blauwiekel R, Williams CH et al. Lactulose Feeding Lowers Cecal Densities of Clostridia in Piglets. JPEN J Parenter Enteral Nutr 2007; 31 (3): 194–8.
16. Collins SM, Denou E, Verdu EF, Bercik P. The putative role of the intestinal microbiota in the irritable bowel syndrome. Dig Liver Dis 2009; 41 (12): 850-3.
17. Derbyshire E, Davies J, Costarelli V et al. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Maternal & Child Nutrition 2006; 2: 127–34, 56.
18. Do Kyung L, Jang S, Baek EH et al. Lactic acid bacteria affect serum cholesterol levels, harmful fecal enzyme activity, and fecal water content. Lipids Health Dis 2009; 8: 21.
19. Dunker-Schmidt C, Shumann С. Lactulose-Pulver-wirksam bei Candida-Mykozen des Darms. Arztliche Praxis. 1998.
20. Eamonn M, Quigley M. Microflora Modulation of Motility. J Neurogastroenterol Motil 2011; 17 (2): 140–7.
21. Eoff JC III, Lembo AJ. Optimal Treatment of Chronic. Constipation in Managed Care: Review and Roundtable Discussion. Suppl. to J Manag Care Pharm JMCP 2008; 9 (14).
22. Foxx-Orenstein AE, McNally MA, Odunsi ST. Update on constipation: one treatment does not fit all. Cleve Clin J Med 2008; 75: 813–24.
23. Huey-Shi Lye, Chiu-Yin Kuan, Joo-Ann Ewe et al. The Improvement of Hypertension by Probiotics: Effects on Cholesterol, Diabetes, Renin, and Phytoestrogens. Int J Mol Sci 2009; 10 (9): 3755–75.
24. Jenssen TG, Holst N, Burhol PG et al. Plasma concentrations of motilin, somatostatin and pancreatic polypeptide, during and after parturition. Act Obstetr Gynaecol Scand 1986; 65: 153–6.
25. Gruenwald J, Busch R, Bentley Ch. Efficacy and tolerability of Laxatan® Granulat in patients with chronic constipation. Clin Exp Gastroenterol 2009; 2: 95–100.
26. Johanson JF. Pharmacotherapeutic Agents for Chronic Constipation: ACG Grade Recommendations. Med Gen Med 2007; 9 (2): 25.
27. Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. Clin Evid 2008; 1411.
28. Niittynen L, Kajander K, Korpela R. Galacto-oligosaccharides and bowel function. Scand J Food Nutr 2007; 51 (2): 62–6.
29. Kamm MA, Farthing MJG, Lennard-Jones JE et al. Steroid hormone abnormalities in women with severe idiopatic constipation. Gut 1991; 32: 80–4.
30. Mann GV, Spoerry A. Studies of a surfactant and cholesteremia in the Maasai. Am J Clin Nutr 1974; 27: 464–9.
31. Mikelsaar M, Zilmer M. Lactobacillus fermentum ME-3 – an antimicrobial and antioxidative probiotic. Ecol Health Dis 2009; 21 (1): 1–27.
32. Parry E, Shields R, Turnbull AC. The effect of pregnancy on the colonic absorption of sodium, potassium and water. Journal of Obstetrics and Gynaecology 1970; 77: 616–9.
33. Pimentel M, Chang C. Inflammation and microflora. Gastroenterol Clin North Am 2011; 40 (1): 69–85.
34. Ponce J, Martínez B, Fernández A et al. Constipation during pregnancy: a longitudinal survey based on self-reported symptoms and the Rome II criteria. Eur J Gastroenterol Hepatol 2008; 20 (1): 56–61.
35. Rose S. Gastrointestinal and Hepatobiliary pathophysiology. Fence Greek Publishing, LLC, Madison 1998.
36. Longo ShA, Moore RC, Canzoneri BJ, RobichauxA. Gastrointestinal Conditions during Pregnancy. Clin Colon Rectal Surg 2010; 23 (2): 80–9.
37. Singh G, Kahler K, Bharathi V et al. Adults with chronic constipation have significant healthcare resource utilization and costs of care. Am J Gastroenterol 2004; 99: S227.
38. Müller-Lissner S. The Pathophysiology, Diagnosis, and Treatment of Constipation. Dtsch Arztebl Int 2009; 106 (25): 424–32.
39. Teraclo A, Ham H. Effect of lactulose on the composition and metabolic activy of the human faecal flora . Microbical Ecol Health Dis 1992; 43–50.
40. Tincello DG, Teare J, Fraser WD. Second trimester concentration of relaxin and pregnancy related incontinence. Eur J Obst Gynaecol and Reproduct Biol 2003; 106: 237–8.
41. Wu JX, Liu XH, Liu W, Ke MY, Fang XC. Investigation of female chronic constipation: a multi-center cross-sectional clinical study. Zhonghua Yi Xue Za Zhi 2009; 89 (18): 1255–8.
2. Бурков С.Г. Запоры беременных: взгляд на проблему. РМЖ, 2006; 8: 1.
3. Буторова Л.И., Калинин А.В. Значение лактулозы в регуляции кишечной микрофлоры. Клинические перспективы гастроэнтерологии, гепатологии, 2002; 6:21–6.
4. El-Tawil AM. Is the DHEAS/cortisol ratio a potential filter for non-operable constipated cases? World J Gastroenterol 2010; 16 (6): 659–62.
5. Czeizel AE, Puhó EH, Bánhidy F. Sex ratio of newborn infants born to pregnant women with severe chronic constipation. Clin Epidemiol 2010; 2: 217–9.
6. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials: Probiotics for functional constipation. World J Gastroenterol 2010; 16 (1): 69–75.
7. Arnaud MJ. Mild dehydration: a risk factor of constipation. Eur J Clin Nutr 2003; 57: S88–S95.
8. Aserko HB, Benett J. Effekt of antibiotic therapy in acute salmonellosis on the faecal excretion of salmonellae. J Med 1969; H 636–400.
9. Bernhardt H, Knoke M. Mycological aspects of gastrointestinal microflora. J Gastroenterol 1997; 32 (Suppl. 222): 102–6.
10. Blaut M. Relationship of prebiotics and food to intestinal microflora. Eur J Nutr 2002; 41 (Suppl. 1): I11–6.
11. Bollongue J, Schumann С. Effect of Lactulose and Lactitol on Colonic Microflora and Enzymatic Activity. J Gastroenterol 1997; 32 (Suppl 222): 41–4.
12. Bonapace ES, Fisher RS. Constipation and diarrhea in pregnancy. Gastroenterology Clinics of North America 1998; 27: 197–211.
13. Bradley CS, Kennedy CM, Turcea AM et al. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110 (6): 1351–7.
14. Christofides ND, Ghatei MA, Bloom SR et al. Decreased plasma motilin concentrations in pregnancy. British Medical Journal 1982; 285: 1453–4.
15. Kien CL, Blauwiekel R, Williams CH et al. Lactulose Feeding Lowers Cecal Densities of Clostridia in Piglets. JPEN J Parenter Enteral Nutr 2007; 31 (3): 194–8.
16. Collins SM, Denou E, Verdu EF, Bercik P. The putative role of the intestinal microbiota in the irritable bowel syndrome. Dig Liver Dis 2009; 41 (12): 850-3.
17. Derbyshire E, Davies J, Costarelli V et al. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Maternal & Child Nutrition 2006; 2: 127–34, 56.
18. Do Kyung L, Jang S, Baek EH et al. Lactic acid bacteria affect serum cholesterol levels, harmful fecal enzyme activity, and fecal water content. Lipids Health Dis 2009; 8: 21.
19. Dunker-Schmidt C, Shumann С. Lactulose-Pulver-wirksam bei Candida-Mykozen des Darms. Arztliche Praxis. 1998.
20. Eamonn M, Quigley M. Microflora Modulation of Motility. J Neurogastroenterol Motil 2011; 17 (2): 140–7.
21. Eoff JC III, Lembo AJ. Optimal Treatment of Chronic. Constipation in Managed Care: Review and Roundtable Discussion. Suppl. to J Manag Care Pharm JMCP 2008; 9 (14).
22. Foxx-Orenstein AE, McNally MA, Odunsi ST. Update on constipation: one treatment does not fit all. Cleve Clin J Med 2008; 75: 813–24.
23. Huey-Shi Lye, Chiu-Yin Kuan, Joo-Ann Ewe et al. The Improvement of Hypertension by Probiotics: Effects on Cholesterol, Diabetes, Renin, and Phytoestrogens. Int J Mol Sci 2009; 10 (9): 3755–75.
24. Jenssen TG, Holst N, Burhol PG et al. Plasma concentrations of motilin, somatostatin and pancreatic polypeptide, during and after parturition. Act Obstetr Gynaecol Scand 1986; 65: 153–6.
25. Gruenwald J, Busch R, Bentley Ch. Efficacy and tolerability of Laxatan® Granulat in patients with chronic constipation. Clin Exp Gastroenterol 2009; 2: 95–100.
26. Johanson JF. Pharmacotherapeutic Agents for Chronic Constipation: ACG Grade Recommendations. Med Gen Med 2007; 9 (2): 25.
27. Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. Clin Evid 2008; 1411.
28. Niittynen L, Kajander K, Korpela R. Galacto-oligosaccharides and bowel function. Scand J Food Nutr 2007; 51 (2): 62–6.
29. Kamm MA, Farthing MJG, Lennard-Jones JE et al. Steroid hormone abnormalities in women with severe idiopatic constipation. Gut 1991; 32: 80–4.
30. Mann GV, Spoerry A. Studies of a surfactant and cholesteremia in the Maasai. Am J Clin Nutr 1974; 27: 464–9.
31. Mikelsaar M, Zilmer M. Lactobacillus fermentum ME-3 – an antimicrobial and antioxidative probiotic. Ecol Health Dis 2009; 21 (1): 1–27.
32. Parry E, Shields R, Turnbull AC. The effect of pregnancy on the colonic absorption of sodium, potassium and water. Journal of Obstetrics and Gynaecology 1970; 77: 616–9.
33. Pimentel M, Chang C. Inflammation and microflora. Gastroenterol Clin North Am 2011; 40 (1): 69–85.
34. Ponce J, Martínez B, Fernández A et al. Constipation during pregnancy: a longitudinal survey based on self-reported symptoms and the Rome II criteria. Eur J Gastroenterol Hepatol 2008; 20 (1): 56–61.
35. Rose S. Gastrointestinal and Hepatobiliary pathophysiology. Fence Greek Publishing, LLC, Madison 1998.
36. Longo ShA, Moore RC, Canzoneri BJ, RobichauxA. Gastrointestinal Conditions during Pregnancy. Clin Colon Rectal Surg 2010; 23 (2): 80–9.
37. Singh G, Kahler K, Bharathi V et al. Adults with chronic constipation have significant healthcare resource utilization and costs of care. Am J Gastroenterol 2004; 99: S227.
38. Müller-Lissner S. The Pathophysiology, Diagnosis, and Treatment of Constipation. Dtsch Arztebl Int 2009; 106 (25): 424–32.
39. Teraclo A, Ham H. Effect of lactulose on the composition and metabolic activy of the human faecal flora . Microbical Ecol Health Dis 1992; 43–50.
40. Tincello DG, Teare J, Fraser WD. Second trimester concentration of relaxin and pregnancy related incontinence. Eur J Obst Gynaecol and Reproduct Biol 2003; 106: 237–8.
41. Wu JX, Liu XH, Liu W, Ke MY, Fang XC. Investigation of female chronic constipation: a multi-center cross-sectional clinical study. Zhonghua Yi Xue Za Zhi 2009; 89 (18): 1255–8.
2. Бурков С.Г. Запоры беременных: взгляд на проблему. РМЖ, 2006; 8: 1.
3. Буторова Л.И., Калинин А.В. Значение лактулозы в регуляции кишечной микрофлоры. Клинические перспективы гастроэнтерологии, гепатологии, 2002; 6:21–6.
4. El-Tawil AM. Is the DHEAS/cortisol ratio a potential filter for non-operable constipated cases? World J Gastroenterol 2010; 16 (6): 659–62.
5. Czeizel AE, Puhó EH, Bánhidy F. Sex ratio of newborn infants born to pregnant women with severe chronic constipation. Clin Epidemiol 2010; 2: 217–9.
6. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials: Probiotics for functional constipation. World J Gastroenterol 2010; 16 (1): 69–75.
7. Arnaud MJ. Mild dehydration: a risk factor of constipation. Eur J Clin Nutr 2003; 57: S88–S95.
8. Aserko HB, Benett J. Effekt of antibiotic therapy in acute salmonellosis on the faecal excretion of salmonellae. J Med 1969; H 636–400.
9. Bernhardt H, Knoke M. Mycological aspects of gastrointestinal microflora. J Gastroenterol 1997; 32 (Suppl. 222): 102–6.
10. Blaut M. Relationship of prebiotics and food to intestinal microflora. Eur J Nutr 2002; 41 (Suppl. 1): I11–6.
11. Bollongue J, Schumann С. Effect of Lactulose and Lactitol on Colonic Microflora and Enzymatic Activity. J Gastroenterol 1997; 32 (Suppl 222): 41–4.
12. Bonapace ES, Fisher RS. Constipation and diarrhea in pregnancy. Gastroenterology Clinics of North America 1998; 27: 197–211.
13. Bradley CS, Kennedy CM, Turcea AM et al. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110 (6): 1351–7.
14. Christofides ND, Ghatei MA, Bloom SR et al. Decreased plasma motilin concentrations in pregnancy. British Medical Journal 1982; 285: 1453–4.
15. Kien CL, Blauwiekel R, Williams CH et al. Lactulose Feeding Lowers Cecal Densities of Clostridia in Piglets. JPEN J Parenter Enteral Nutr 2007; 31 (3): 194–8.
16. Collins SM, Denou E, Verdu EF, Bercik P. The putative role of the intestinal microbiota in the irritable bowel syndrome. Dig Liver Dis 2009; 41 (12): 850-3.
17. Derbyshire E, Davies J, Costarelli V et al. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Maternal & Child Nutrition 2006; 2: 127–34, 56.
18. Do Kyung L, Jang S, Baek EH et al. Lactic acid bacteria affect serum cholesterol levels, harmful fecal enzyme activity, and fecal water content. Lipids Health Dis 2009; 8: 21.
19. Dunker-Schmidt C, Shumann С. Lactulose-Pulver-wirksam bei Candida-Mykozen des Darms. Arztliche Praxis. 1998.
20. Eamonn M, Quigley M. Microflora Modulation of Motility. J Neurogastroenterol Motil 2011; 17 (2): 140–7.
21. Eoff JC III, Lembo AJ. Optimal Treatment of Chronic. Constipation in Managed Care: Review and Roundtable Discussion. Suppl. to J Manag Care Pharm JMCP 2008; 9 (14).
22. Foxx-Orenstein AE, McNally MA, Odunsi ST. Update on constipation: one treatment does not fit all. Cleve Clin J Med 2008; 75: 813–24.
23. Huey-Shi Lye, Chiu-Yin Kuan, Joo-Ann Ewe et al. The Improvement of Hypertension by Probiotics: Effects on Cholesterol, Diabetes, Renin, and Phytoestrogens. Int J Mol Sci 2009; 10 (9): 3755–75.
24. Jenssen TG, Holst N, Burhol PG et al. Plasma concentrations of motilin, somatostatin and pancreatic polypeptide, during and after parturition. Act Obstetr Gynaecol Scand 1986; 65: 153–6.
25. Gruenwald J, Busch R, Bentley Ch. Efficacy and tolerability of Laxatan® Granulat in patients with chronic constipation. Clin Exp Gastroenterol 2009; 2: 95–100.
26. Johanson JF. Pharmacotherapeutic Agents for Chronic Constipation: ACG Grade Recommendations. Med Gen Med 2007; 9 (2): 25.
27. Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. Clin Evid 2008; 1411.
28. Niittynen L, Kajander K, Korpela R. Galacto-oligosaccharides and bowel function. Scand J Food Nutr 2007; 51 (2): 62–6.
29. Kamm MA, Farthing MJG, Lennard-Jones JE et al. Steroid hormone abnormalities in women with severe idiopatic constipation. Gut 1991; 32: 80–4.
30. Mann GV, Spoerry A. Studies of a surfactant and cholesteremia in the Maasai. Am J Clin Nutr 1974; 27: 464–9.
31. Mikelsaar M, Zilmer M. Lactobacillus fermentum ME-3 – an antimicrobial and antioxidative probiotic. Ecol Health Dis 2009; 21 (1): 1–27.
32. Parry E, Shields R, Turnbull AC. The effect of pregnancy on the colonic absorption of sodium, potassium and water. Journal of Obstetrics and Gynaecology 1970; 77: 616–9.
33. Pimentel M, Chang C. Inflammation and microflora. Gastroenterol Clin North Am 2011; 40 (1): 69–85.
34. Ponce J, Martínez B, Fernández A et al. Constipation during pregnancy: a longitudinal survey based on self-reported symptoms and the Rome II criteria. Eur J Gastroenterol Hepatol 2008; 20 (1): 56–61.
35. Rose S. Gastrointestinal and Hepatobiliary pathophysiology. Fence Greek Publishing, LLC, Madison 1998.
36. Longo ShA, Moore RC, Canzoneri BJ, RobichauxA. Gastrointestinal Conditions during Pregnancy. Clin Colon Rectal Surg 2010; 23 (2): 80–9.
37. Singh G, Kahler K, Bharathi V et al. Adults with chronic constipation have significant healthcare resource utilization and costs of care. Am J Gastroenterol 2004; 99: S227.
38. Müller-Lissner S. The Pathophysiology, Diagnosis, and Treatment of Constipation. Dtsch Arztebl Int 2009; 106 (25): 424–32.
39. Teraclo A, Ham H. Effect of lactulose on the composition and metabolic activy of the human faecal flora . Microbical Ecol Health Dis 1992; 43–50.
40. Tincello DG, Teare J, Fraser WD. Second trimester concentration of relaxin and pregnancy related incontinence. Eur J Obst Gynaecol and Reproduct Biol 2003; 106: 237–8.
41. Wu JX, Liu XH, Liu W, Ke MY, Fang XC. Investigation of female chronic constipation: a multi-center cross-sectional clinical study. Zhonghua Yi Xue Za Zhi 2009; 89 (18): 1255–8.
________________________________________________
2. Бурков С.Г. Запоры беременных: взгляд на проблему. РМЖ, 2006; 8: 1.
3. Буторова Л.И., Калинин А.В. Значение лактулозы в регуляции кишечной микрофлоры. Клинические перспективы гастроэнтерологии, гепатологии, 2002; 6:21–6.
4. El-Tawil AM. Is the DHEAS/cortisol ratio a potential filter for non-operable constipated cases? World J Gastroenterol 2010; 16 (6): 659–62.
5. Czeizel AE, Puhó EH, Bánhidy F. Sex ratio of newborn infants born to pregnant women with severe chronic constipation. Clin Epidemiol 2010; 2: 217–9.
6. Chmielewska A, Szajewska H. Systematic review of randomised controlled trials: Probiotics for functional constipation. World J Gastroenterol 2010; 16 (1): 69–75.
7. Arnaud MJ. Mild dehydration: a risk factor of constipation. Eur J Clin Nutr 2003; 57: S88–S95.
8. Aserko HB, Benett J. Effekt of antibiotic therapy in acute salmonellosis on the faecal excretion of salmonellae. J Med 1969; H 636–400.
9. Bernhardt H, Knoke M. Mycological aspects of gastrointestinal microflora. J Gastroenterol 1997; 32 (Suppl. 222): 102–6.
10. Blaut M. Relationship of prebiotics and food to intestinal microflora. Eur J Nutr 2002; 41 (Suppl. 1): I11–6.
11. Bollongue J, Schumann С. Effect of Lactulose and Lactitol on Colonic Microflora and Enzymatic Activity. J Gastroenterol 1997; 32 (Suppl 222): 41–4.
12. Bonapace ES, Fisher RS. Constipation and diarrhea in pregnancy. Gastroenterology Clinics of North America 1998; 27: 197–211.
13. Bradley CS, Kennedy CM, Turcea AM et al. Constipation in pregnancy: prevalence, symptoms, and risk factors. Obstet Gynecol 2007; 110 (6): 1351–7.
14. Christofides ND, Ghatei MA, Bloom SR et al. Decreased plasma motilin concentrations in pregnancy. British Medical Journal 1982; 285: 1453–4.
15. Kien CL, Blauwiekel R, Williams CH et al. Lactulose Feeding Lowers Cecal Densities of Clostridia in Piglets. JPEN J Parenter Enteral Nutr 2007; 31 (3): 194–8.
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Авторы
И.Ю.Фофанова
ФГУ Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова
Минздравсоцразвития РФ
V.I.Kulakov State Research Centre of obstetrics, gynecology and perinatology of the Ministry of Public Health and social development of the Russian Federation
ФГУ Научный центр акушерства, гинекологии и перинатологии им. В.И.Кулакова
Минздравсоцразвития РФ
________________________________________________
V.I.Kulakov State Research Centre of obstetrics, gynecology and perinatology of the Ministry of Public Health and social development of the Russian Federation
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