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만성 기능성 변비의 진단과 치료 임상 진료지침 개정안

Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition

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참고문헌

키워드

주제분류내과학

초록

최근 발표된 만성 기능성 변비의 진단과 치료 임상 진료지침 개정안은 2011년 발표된 진료지침과는 달리, 다학제 참여를 통해 전문성을 높였고, 진단에 관한 진료지침을 추가하였으며, 새로운 약제를 추가하고 최근 연구 결과에 근거하여권고 등급을 적절하게 변경하였다. 진단 및 치료 방법의 여러 대안을 제시하고, 장ㆍ단점을 요약하며, 약제를 포함하는치료 방법의 선택 기준, 각 치료 방법이 선호되는 임상 상황및 주의사항 등을 포함하는 구체적인 지침을 제시하고자 하였다. 이를 통해 1차 의료기관의 개원의 및 2, 3차 의료기관의 봉직의뿐만 아니라 소화기내과, 소화기외과 및 영상의학과 등 다양한 의료 분야에서 적정 진료를 위한 의사 결정에도움을 주고, 전공의 및 병원 근무 인력에 대해서도 진료 원칙의 길잡이 역할을 하며 교육 자료로도 활용되도록 하였다. 또한 환자에게는 제공받는 서비스의 예측성을 높이고 정보에 입각한 선택을 하도록 도움을 줄 수 있으며, 환자에 대한교육 및 의사 소통 자료로도 활용될 수 있다. 국내 실정에맞고 임상에서 적용할 수 있는 보다 구체적인 진료지침 개정안을 제공함으로써 변비의 진단 및 치료에 실제적인 도움이될 수 있기를 기대한다.

Abstract

The Korean Society of Neurogastroenterology and Motility first published guidelines for chronic constipation in 2005 and was updated in 2011. Although the guidelines were updated using evidence-based process, they lacked multidisciplinary participation and did not include a diagnostic approach for chronic constipation. This study includes guidelines for diagnosis and treatment of chronic constipation to realistically fit the situation in Korea and to be applicable to clinical practice. The guideline development was based upon the adaptation method because research evidence was limited in Korea, and an organized multidisciplinary group carried out systematical literature review and series of evidence-based evaluations. Six guidelines were selected using the Appraisal of Guidelines for Research & Evaluation II process. A total 37 recommendations were adopted, including 4 concerning the definition and risk factors of chronic constipation, 8 regarding diagnoses, and 25 regarding treatments. The guidelines are intended to help primary physicians and general health professionals in clinical practice in Korea, to provide the principles of medical treatment to medical students, residents, and other healthcare professionals, and to help patients for choosing medical services based on the information. These guidelines will be updated and revised periodically to reflect new diagnostic and therapeutic methods. (Korean J Med 2016;91:114-130)

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