Loeys-Dietz Gastroenterology and Allergy Q&A
9:08-11:08
Very frequently in connective tissue disorders such as Loeys-Dietz syndrome you will see constipation very frequently.
ロイス・ディーツ症候群のような結合組織疾患では、頻繁に便秘がみられます。
We will have people use something called Miralax, other names for it, glycolax or clearlax, the active ingredient is Peg 3350. This is a medication doesn't, that does not work if you take it intermittently. If you only take it when you have a problem with constipation you're actually going to probably get more trouble than not.
そうした患者さんには、Miralax（別名：glycolax, clearlax 有効成分：ポリエチレングリコール 3350）という薬を処方します。この薬は飲んだり飲まなかったりすると効果がなく、問題があるときだけ服用すると、逆に便秘が悪化することになります。
If it's been long standing you may need to do a clean out beforehand and if we have specific questions about that we can go into that in more detail.
長期にわたる便秘では、Miralaxの服用前に腸内を空っぽにする必要があるかもしれません。個別の質問については、後ほど回答したいと思います。
Younger children, step stool basically in front of the toilet so that their feet aren't hanging can put those pelvic muscles in the appropriate position that can help alleviate some of the problems with emptying the intestines when they have a bowel movement.
幼いお子さんの場合、足をブラブラさせないように、便器の前に踏み台を置くことで、骨盤の筋肉を適切な位置に保つことができますので、排便しやすくなることがあります。
Long-term constipation can lead to the muscles not acting properly and very frequently when we see patients with Loeys-Dietz syndrome who are a little bit older we see that they may have this pelvic floor dyssynergy. This can be diagnosed with something called anorectal manometry and it's treated with pelvic floor physical therapy. To be honest, however, anorectal manometry is not absolutely needed. If you are someone with older elementary school student who has had constipation for several years almost assuredly there is some pelvic floor dyssynergy and pelvic floor physical therapy can be really useful in that situation.
便秘が長期間に及ぶ場合には、骨盤底筋が適切に動かなくなっていることもあり、多少年齢を重ねたLDS患者さんで頻繁に目にします。こうした状態を骨盤底筋の共同運動障害と呼びます。肛門内圧検査と呼ばれる検査で診断可能で、治療は骨盤底筋の理学療法を行います。実際のところは、肛門内圧検査は必ずしも必要というわけではありません。小学校高学年の患者さんで、数年間便秘が続いている場合には、ほぼ確実に骨盤底筋の共同運動障害がありますので、この場合、骨盤底筋に対する理学療法が非常に有効である可能性があります。
Also if you have a younger child who because of their constipation is having painful bowel movements and they're afraid to use the toilet cognitive behavioral therapist or CBT can be really, really helpful in those situations in order to create a situation where they're not afraid of using the toilet, which will obviously complicate the management of constipation.
また、お子さんが便秘による排便時の痛みがあることでトイレに行きたがらない場合には、認知行動療法が非常に有効です。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
