asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2026-002asurgery-635Research ArticleОБМЕН ОПЫТОМEXCHANGE OF EXPERIENCE | PRACTICEЭффективные стратегии регуляции стула у хирургических пациентов: в фокусе пикосульфат натрияEffective strategies for stool regulation in surgical patients: The focus is on sodium picosulfatehttps://orcid.org/0000-0002-1597-1876ТруханД. И.TrukhanD. I.

Трухан Дмитрий Иванович, д.м.н., доцент, профессор кафедры поликлинической терапии и внутренних болезней

644043, Омск, ул. Ленина, д. 12

Dmitry I. Trukhan, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Polyclinic Therapy and Internal Diseases

12, Lenin St., Omsk, 644043

dmitry_trukhan@mail.ruhttps://orcid.org/0000-0003-0385-8232ДеговцовЕ. Н.DegovtsovE. N.

Деговцов Евгений Николаевич, д.м.н., заведующий кафедрой госпитальной хирургии имени Н.С. Макохи

644043, Омск, ул. Ленина, д. 12

Evgeny N. Degovtsov, Dr. Sci. (Med.), Head of the Department of Hospital Surgery named after N.S. Makohi

12, Lenin St., Omsk, 644043

edego2001@mail.ruhttps://orcid.org/0000-0001-6270-4992КалиниченкоД. А.KalinichenkoD. A.

Калиниченко Дмитрий Анатольевич, к.м.н., врач-уролог, доцент госпитальной хирургии имени Н.С. Макохи

644043, Омск, ул. Ленина, д. 12

Dmitry A. Kalinichenko, Cand. Sci. (Med.), Urologist, Associate Professor of Hospital Surgery named after N.S. Makohi

12, Lenin St., Omsk, 644043

kalinaur@mail.ruhttps://orcid.org/0009-0009-9935-2164ШугановаП. В.ShuganovaP. V.

Шуганова Полина Витальевна, ассистент кафедры поликлинической терапии и внутренних болезней

644043, Омск, ул. Ленина, д. 12

Polina V. Shuganova, Assistant of the Department of Polyclinic Therapy and Internal Diseases

12, Lenin St., Omsk, 644043

docanilop@mail.ruОмский государственный медицинский университетРоссияOmsk State Medical UniversityRussian Federation202607062026231150161Copyright © Трухан Д.И., Деговцов Е.Н., Калиниченко Д.А., Шуганова П.В., 20262026Трухан Д.И., Деговцов Е.Н., Калиниченко Д.А., Шуганова П.В.Trukhan D.I., Degovtsov E.N., Kalinichenko D.A., Shuganova P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/635

Согласно статистическим данным, в разных странах запором страдают до 20% взрослого населения. В хирургической практике наличие у пациента запора ставит перед врачом-хирургом 2 актуальные задачи: диагностическую в аспекте дифференциальной диагностики возможных причин запора и лечебную. В первой части обзорной статьи рассмотрены возможные заболевания и состояния, которые встречаются в реальной хирургической практике и в клинической картине которых присутствует синдром запора. Залогом точной диагностики и успешного в последующем лечения является оптимальная подготовка пациента к инструментальным исследованиям толстого кишечника. Использование пикосульфата натрия в различных схемах подготовки кишечника к колоноскопии способствует лучшей переносимости и ее успешному проведению. Пикосульфат натрия – один из наиболее часто употребляемых и эффективных препаратов, относится к группе синтетических стимулирующих слабительных. Во второй части обзорной статьи на основании проведенного поиска в информационных базах Pubmed, Scopus и eLIBRARY.RU статей, опубликованных до 15.07.2025, рассматриваются эффективность и безопасность пикосульфата натрия с акцентом на хирургическую практику. Применение пикосульфата натрия продемонстрировало его эффективность и безопасность при атонических запорах, для регулирования стула (геморрой, проктит, трещины ануса), для подготовки к хирургическим операциям, инструментальным и рентгенологическим исследованиям, в послеоперационном периоде при длительной иммобилизации. Пикосульфат натрия рассматривается в качестве препарата выбора у пациентов различных категорий, в том числе у коморбидных пациентов, т.к. не всасывается в системный кровоток, поэтому комбинация с другими препаратами является безопасной и эффективной.

According to statistics, up to 20% of the adult population in different countries suffers from constipation. In surgical practice, constipation presents two pressing challenges for surgeons: diagnostic, in terms of differential diagnosis of possible causes, and therapeutic. The first part of the review article examines possible diseases and conditions encountered in real-life surgical practice, whose clinical presentation includes constipation. The key to an accurate diagnosis and successful subsequent treatment is optimal patient preparation for colonoscopy. The use of sodium picosulfate in various bowel preparation regimens for colonoscopy promotes better tolerability and a successful colonoscopy. Sodium picosulfate is one of the most commonly used and effective medications and belongs to the group of synthetic stimulant laxatives. The second part of the review article, based on a search of Pubmed, Scopus, and eLIBRARY.RU databases, examines articles published before July 15, 2025, examining the efficacy and safety of sodium picosulfate, with a focus on surgical practice. The use of sodium picosulfate has demonstrated its effectiveness and safety in atonic constipation, for stool regulation (hemorrhoids, proctitis, anal fissures), for preparation for surgical operations, instrumental and radiological examinations, and in the postoperative period during prolonged immobilization. Sodium picosulfate is considered as the drug of choice in various categories of patients, including those with comorbidities, since it is not absorbed into the systemic circulation, so the combination with other drugs is safe and effective.

хирургическая практиказапорпричинные факторыдифференциальный диагнозподготовка к инструментальным исследованиям толстого кишечникадиагностикалечениестимулирующие слабительныепикосульфат натрияРегулакс® Пикосульфатsurgical practiceconstipationcausal factorsdifferential diagnosispreparation for instrumental studies of the large intestinediagnosistreatmentstimulant laxativessodium picosulfateRegulax® PicosulfateReferencesАлешин ДВ, Ачкасов СИ, Баранская ЕК, Ивашкин ВТ, Куликова НД, Лапина ТЛ и др. Клинические рекомендации. Запор. 2024. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/274_3.Алешин ДВ, Ачкасов СИ, Баранская ЕК, Ивашкин ВТ, Куликова НД, Лапина ТЛ и др. Клинические рекомендации. Запор. 2024. Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/274_3.Drossman DA, Hasler WL. Rome IV – Functional GI disorders: disorders of Gut-Brain interaction. Gastroenterology. 2016;150(6):1257–1261. https://doi.org/10.1053/j.gastro.2016.03.035.Drossman DA, Hasler WL. Rome IV – Functional GI disorders: disorders of Gut-Brain interaction. Gastroenterology. 2016;150(6):1257–1261. https://doi.org/10.1053/j.gastro.2016.03.035.Тарасова ЛВ, Трухан ДИ. Болезни кишечника. Клиника, диагностика и лечение. СПб.: СпецЛит; 2022. 222 с. Режим доступа: https://elibrary.ru/txylvk.Тарасова ЛВ, Трухан ДИ. Болезни кишечника. Клиника, диагностика и лечение. СПб.: СпецЛит; 2022. 222 с. Режим доступа: https://elibrary.ru/txylvk.Rao SSC, Lacy BE, Emmanuel A, Müller-Lissner S, Pohl D et al. Recognizing and Defining Occasional Constipation: Expert Consensus Recommendations. Am J Gastroenterol. 2022;117(11):1753–1758. https://doi.org/10.14309/ajg.0000000000001945.Rao SSC, Lacy BE, Emmanuel A, Müller-Lissner S, Pohl D et al. Recognizing and Defining Occasional Constipation: Expert Consensus Recommendations. Am J Gastroenterol. 2022;117(11):1753–1758. https://doi.org/10.14309/ajg.0000000000001945.Heidelbaugh J, Martinez de Andino N, Pineles D, Poppers DM. Diagnosing Constipation Spectrum Disorders in a Primary Care Setting. J Clin Med. 2021;10(5):1092. https://doi.org/10.3390/jcm10051092.Heidelbaugh J, Martinez de Andino N, Pineles D, Poppers DM. Diagnosing Constipation Spectrum Disorders in a Primary Care Setting. J Clin Med. 2021;10(5):1092. https://doi.org/10.3390/jcm10051092.Деговцов ЕН, Трухан ДИ, Никоненко ВА, Косенок ВИ. Синдром запора в хирургической практике: актуальные аспекты диагностики и лечения. Амбулаторная хирургия. 2020;(1-2):46–56. https://doi.org/10.21518/1995-1477-2020-1-2-46-56.Degovtsov EN, Trukhan DI, Nikonenko VA, Kosenok VK. Patient with constipation syndrome at the ambulatory polyclinic reception: actual aspects of diagnosis and treatment. Ambulatornaya Khirurgiya. 2020;(1-2):46–56. (In Russ.) https://doi.org/10.21518/1995-1477-2020-1-2-46-56.Тарасова ЛВ, Трухан ДИ. «Острый живот» в практике врача-терапевта. Справочник поликлинического врача. 2014;(2):51–55. Режим доступа: https://elibrary.ru/sfpuqf.Tarasova LV, Trukhan DI. “Acute abdomen” in the practice of a general practitioner.Spravochnik Poliklinicheskogo Vracha. 2014;(2):51–55. (In Russ.) Available at: https://elibrary.ru/sfpuqf.Трухан ДИ, Филимонов СН. Дифференциальный диагноз основных гастроэнтерологических синдромов и симптомов. М.: Практическая медицина; 2016. 168 с. Режим доступа: https://gastroscan.ru/literature/authors/13898?sphrase_id=526801.Трухан ДИ, Филимонов СН. Дифференциальный диагноз основных гастроэнтерологических синдромов и симптомов. М.: Практическая медицина; 2016. 168 с. Режим доступа: https://gastroscan.ru/literature/authors/13898?sphrase_id=526801.Joly F, Amiot A, Coffin B, Lavergne-Slove A, Messing B, Bouhnik Y. Chronic intestinal pseudo-obstruction. Gastroenterol Clin Biol. 2006;30(8-9):975–985. https://doi.org/10.1016/s0399-8320(06)73359-0.Joly F, Amiot A, Coffin B, Lavergne-Slove A, Messing B, Bouhnik Y. Chronic intestinal pseudo-obstruction. Gastroenterol Clin Biol. 2006;30(8-9):975–985. https://doi.org/10.1016/s0399-8320(06)73359-0.Egal A, Jouët P, Lamarque D. Chronic intestinal pseudo-obstruction in adults. Rev Med Interne. 2018;39(10):792–799. https://doi.org/10.1016/j.revmed.2018.03.010.Egal A, Jouët P, Lamarque D. Chronic intestinal pseudo-obstruction in adults. Rev Med Interne. 2018;39(10):792–799. https://doi.org/10.1016/j.revmed.2018.03.010.Lacy BE, Patel NK. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J Clin Med. 2017;6(11):99. https://doi.org/10.3390/jcm6110099.Lacy BE, Patel NK. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. J Clin Med. 2017;6(11):99. https://doi.org/10.3390/jcm6110099.Sákra L, Šiller J. Obstructed defecation syndrome – review article. Rozhl Chir. 2017;96(6):247–251. Available at: https://pubmed.ncbi.nlm.nih.gov/28931290/.Sákra L, Šiller J. Obstructed defecation syndrome – review article. Rozhl Chir. 2017;96(6):247–251. Available at: https://pubmed.ncbi. nlm.nih.gov/28931290/.Cuda T, Gunnarsson R, de Costa A. Symptoms and diagnostic criteria of acquired Megacolon – a systematic literature review. BMC Gastroenterol. 2018;18(1):25. https://doi.org/10.1186/s12876-018-0753-7.Cuda T, Gunnarsson R, de Costa A. Symptoms and diagnostic criteria of acquired Megacolon – a systematic literature review. BMC Gastroenterol. 2018;18(1):25. https://doi.org/10.1186/s12876-018-0753-7.Constantin A, Achim F, Spinu D, Socea B, Predescu D. Idiopathic Megacolon-Short Review. Diagnostics. 2021;11(11):2112. https://doi.org/10.3390/diagnostics11112112.Constantin A, Achim F, Spinu D, Socea B, Predescu D. Idiopathic Megacolon-Short Review. Diagnostics. 2021;11(11):2112. https://doi.org/10.3390/diagnostics11112112.Bodnar OB, Vatamanesku LI, Bodnar BM, Sydorchuk RI. Surgical treatment of chronic colostasis in children: a ten-year experience. Rev Med Chir Soc Med Nat Iasi. 2014;118(3):661–666. Available at: https://pubmed.ncbi.nlm.nih.gov/25341281/.Bodnar OB, Vatamanesku LI, Bodnar BM, Sydorchuk RI. Surgical treatment of chronic colostasis in children: a ten-year experience. Rev Med Chir Soc Med Nat Iasi. 2014;118(3):661–666. Available at: https://pubmed.ncbi.nlm.nih.gov/25341281/.Wester T, Granström AL.Hirschsprung disease-Bowel function beyond childhood. Semin Pediatr Surg. 2017;26(5):322–327. https://doi.org/10.1053/j.sempedsurg.2017.09.008.Wester T, Granström AL.Hirschsprung disease-Bowel function beyond childhood. Semin Pediatr Surg. 2017;26(5):322–327. https://doi.org/10.1053/j.sempedsurg.2017.09.008.Heuckeroth RO. Hirschsprung disease – integrating basic science and clinical medicine to improve outcomes. Nat Rev Gastroenterol Hepatol. 2018;15(3):152–167. https://doi.org/10.1038/nrgastro.2017.149.Heuckeroth RO. Hirschsprung disease – integrating basic science and clinical medicine to improve outcomes. Nat Rev Gastroenterol Hepatol. 2018;15(3):152–167. https://doi.org/10.1038/nrgastro.2017.149.Xiao J, Yang S, Xiang L, Qin B, You J, Dong M et al. Analysis of the causes of redo pull-through for recurrent constipation and the risk factors affecting the prognosis of the Hirschsprung’s disease: a single-center retrospective study and systematic review. BMC Pediatr. 2025;25(1):313. https://doi.org/10.1186/s12887-025-05680-y.Xiao J, Yang S, Xiang L, Qin B, You J, Dong M et al. Analysis of the causes of redo pull-through for recurrent constipation and the risk factors affecting the prognosis of the Hirschsprung’s disease: a single-center retrospective study and systematic review. BMC Pediatr. 2025;25(1):313. https://doi.org/10.1186/s12887-025-05680-y.Пахомова ИГ, Лелякова АА. Проблема запора в практике врача амбулаторного звена. Медицинский совет. 2024;18(15):158–165. https://doi.org/10.21518/ms2024-340.Pakhomova IG, Lelyakova AA. The problem of constipation in the practice of an outpatient doctor. Meditsinskiy Sovet. 2024;18(15):158–165. (In Russ.) https://doi.org/10.21518/ms2024-340.Левченко СВ. Этиология и патогенез дивертикулярной болезни толстой кишки. Экспериментальная и клиническая гастроэнтерология. 2011;(2):93–96. Режим доступа: https://elibrary.ru/ndcvxr.Levchenko SV. Etiology and pathogenesis of diverticular disease of the colon. Experimental and Clinical Gastroenterology. 2011;(2):93–96. (In Russ.) Available at: https://elibrary.ru/ndcvxr.Ривкин ВЛ. Амбулаторное обследование проктологического больного. Справочник поликлинического врача. 2009;(11):71–73. Режим доступа: https://elibrary.ru/tfrtkj.Rivkin VL. Outpatient examination of a proctological patient. Spravochnik Poliklinicheskogo Vracha. 2009;(11):71–73. (In Russ.) Available at: https://elibrary.ru/tfrtkj.Ривкин ВЛ. Проктит и парапроктит. Справочник поликлинического врача. 2011;(11):54–56. Режим доступа: https://elibrary.ru/twnzzp.Rivkin VL. Proctitis and paraproctitis. Spravochnik Poliklinicheskogo Vracha. 2011;(11):54–56. (In Russ.) Available at: https://elibrary.ru/twnzzp.Andromanakos N, Skandalakis P, Troupis T, Filippou D. Constipation of anorectal outlet obstruction: pathophysiology, evaluation and management. J Gastroenterol Hepatol. 2006;21(4):638–646. https://doi.org/10.1111/j.1440-1746.2006.04333.x.Andromanakos N, Skandalakis P, Troupis T, Filippou D. Constipation of anorectal outlet obstruction: pathophysiology, evaluation and management. J Gastroenterol Hepatol. 2006;21(4):638–646. https://doi.org/10.1111/j.1440-1746.2006.04333.x.D’Amico DF, Angriman I. Descending perineum syndrome: iatrogenic or spontaneous pathology? Chir Ital. 2000;52(6):625–630. (In Italian) Available at: https://pubmed.ncbi.nlm.nih.gov/11199996/.D’Amico DF, Angriman I. Descending perineum syndrome: iatrogenic or spontaneous pathology? Chir Ital. 2000;52(6):625–630. (In Italian) Available at: https://pubmed.ncbi.nlm.nih.gov/11199996/.Кузнецова ИВ, Успенская ЮБ. Заболевания кишечника и запоры в практике акушера-гинеколога. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2015;25(1):30–36. Режим доступа: https://elibrary.ru/uiorwn.Kuznetsova IV, Uspenskaya YuB. Bowel diseases and constipation in practice of the obstetrician and gynecologist. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2015;25(1):30–36. (In Russ.) Available at: https://elibrary.ru/uiorwn.Knowles CH, Scott SM, Lunniss PJ. Slow transit constipation: a disorder of pelvic autonomic nerves? Dig Dis Sci. 2001;46(2):389–401. https://doi.org/10.1023/a:1005665218647.Knowles CH, Scott SM, Lunniss PJ. Slow transit constipation: a disorder of pelvic autonomic nerves? Dig Dis Sci. 2001;46(2):389–401. https://doi.org/10.1023/a:1005665218647.Quinn M. Origins of Western diseases. J R Soc Med. 2011;104(11):449–456. https://doi.org/10.1258/jrsm.2011.110014.Quinn M. Origins of Western diseases. J R Soc Med. 2011;104(11):449–456. https://doi.org/10.1258/jrsm.2011.110014.Титов АЮ, Мудров АА. Особенности клинической картины и характер функциональных нарушений у больных ректоцеле. Consilium Medicum. 2008;(8):143–147. Режим доступа: https://elibrary.ru/rbsqvv.Titov AJu, Mudrov AA. Features of the clinical picture and the nature of functional disorders in patients with rectocele. Consilium Medicum. 2008;(8):143–147. (In Russ.) Available at: https://elibrary.ru/rbsqvv.Ривкин ВЛ. Колоректальная хирургия: традиции и новации. Consilium Medicum. Гастроэнтерология (Прил.). 2019;(1):70–73. Режим доступа: https://omnidoctor.ru/upload/iblock/a37/a37fa7e4a51a289f80c4c1237e6f9e0e.pdf.Rivkin VL. Colorectal surgery: traditions and innovations. Consilium Medicum. Gastroenterology (Suppl.). 2019;(1):70–73. (In Russ.) Available at: https://omnidoctor.ru/upload/iblock/a37/a37fa7e4a51a289f80c4c1237e6f9e0e.pdf.Hussain ZH, Whitehead DA, Lacy BE. Fecal impaction. Curr Gastroenterol Rep. 2014;16(9):404. https://doi.org/10.1007/s11894-014-0404-2.Hussain ZH, Whitehead DA, Lacy BE. Fecal impaction. Curr Gastroenterol Rep. 2014;16(9):404. https://doi.org/10.1007/s11894-014-0404-2.Louwagie V, Steinman MD, Wang MH. Fecal impaction in adults. JAAPA. 2023;36(5):19–22. https://doi.org/10.1097/01.JAA.0000923532.69484.95.Louwagie V, Steinman MD, Wang MH. Fecal impaction in adults. JAAPA. 2023;36(5):19–22. https://doi.org/10.1097/01.JAA.0000923532.69484.95.Трухан ДИ, Тарасова ЛВ. Клиника, диагностика и лечение хронического дуоденита. Экспериментальная и клиническая гастроэнтерология. 2012;(11):104–114. Режим доступа: https://elibrary.ru/selubp.Trukhan DI, Tarasova LV. The clinical symptoms, diagnostics and treatment of chronic duodenitis. Experimental and Clinical Gastroenterology. 2012;(11):104–114. (In Russ.) Available at: https://elibrary.ru/selubp.Трухан ДИ, Викторова ИА, Иванова ДС. Актуальные аспекты клиники, диагностики и лечения заболеваний желчного пузыря и желчевыводящих путей. СПб.: СпецЛит; 2023. 127 с. Режим доступа: https://elibrary.ru/cuhzdl.Трухан ДИ, Викторова ИА, Иванова ДС. Актуальные аспекты клиники, диагностики и лечения заболеваний желчного пузыря и желчевыводящих путей. СПб.: СпецЛит; 2023. 127 с. Режим доступа: https://elibrary.ru/cuhzdl.Stocchi F, Torti M. Constipation in Parkinson’s Disease. Int Rev Neurobiol. 2017;134:811–826. https://doi.org/10.1016/bs.irn.2017.06.003.Stocchi F, Torti M. Constipation in Parkinson’s Disease. Int Rev Neurobiol. 2017;134:811–826. https://doi.org/10.1016/bs.irn.2017.06.003.Трухан ДИ, Викторова ИА. Нефрология. Эндокринология. Гематология. СПб.: СпецЛит; 2023. 352 с. Режим доступа: https://www.elibrary.ru/dqfpmu.Трухан ДИ, Викторова ИА. Нефрология. Эндокринология. Гематология. СПб.: СпецЛит; 2023. 352 с. Режим доступа: https://www.elibrary.ru/dqfpmu.Трухан ДИ, Голошубина ВВ, Белкина ЛВ. Коморбидность в гинекологии: в фокусе – предменструальный синдром и синдром раздраженного кишечника. Клинический разбор в общей медицине. 2023;4(9):78–84. https://doi.org/10.47407/kr2023.4.9.00313.Trukhan DI, Goloshubina VV, Belkina LV. Comorbidity in gynecology: focus on premenstrual syndrome and irritable bowel syndrome. Clinical Review for General Practice. 2023;4(9):78–84 (In Russ.) https://doi.org/10.47407/kr2023.4.9.00313.Barkun A, Chiba N, Enns R, Marcon M, Natsheh S, Pham C et al. Commonly used preparations for colonoscopy: efficacy, tolerability, and safety – a Canadian Association of Gastroenterology position paper. Can J Gastroenterol. 2006;20(11):699–710. https://doi.org/10.1155/2006/915368.Barkun A, Chiba N, Enns R, Marcon M, Natsheh S, Pham C et al. Commonly used preparations for colonoscopy: efficacy, tolerability, and safety – a Canadian Association of Gastroenterology position paper. Can J Gastroenterol. 2006;20(11):699–710. https://doi.org/10.1155/2006/915368.Atreja A, Nepal S, Lashner BA. Making the most of currently available bowel preparations for colonoscopy. Cleve Clin J Med. 2010;77(5):317–326. https://doi.org/10.3949/ccjm.77a.09122.Atreja A, Nepal S, Lashner BA. Making the most of currently available bowel preparations for colonoscopy. Cleve Clin J Med. 2010;77(5):317–326. https://doi.org/10.3949/ccjm.77a.09122.Сказываева ЕВ, Лапинский ИВ, Пушкина АВ, Авалуева ЕБ, Ткаченко ЕИ, Медведева ОИ. Повышение эффективности подготовки пациентов к колоноскопии с использованием комбинированной схемы на основе макрогола. Медицинский алфавит. 2016;1(5):10–14. Режим доступа: https://elibrary.ru/xuxyyf.Skazyvaeva EV, Lapinskiy IV, Pushkina AV, Avalueva EB, Tkachenko EI, Medvedeva OI. Improving effectiveness of patients’ preparation to colonoscopy using combined scheme based on macrogol. Medical Alphabet. 2016;1(5):10–14. (In Russ.) Available at: https://elibrary.ru/xuxyyf.Katz PO, Rex DK, Epstein M, Grandhi NK, Vanner S, Hookey LC et al. A dual-action, low-volume bowel cleanser administered the day before colonoscopy: results from the SEE CLEAR II study. Am J Gastroenterol. 2013;108(3):401–409. https://doi.org/10.1038/ajg.2012.441.Katz PO, Rex DK, Epstein M, Grandhi NK, Vanner S, Hookey LC et al. A dual-action, low-volume bowel cleanser administered the day before colonoscopy: results from the SEE CLEAR II study. Am J Gastroenterol. 2013;108(3):401–409. https://doi.org/10.1038/ajg.2012.441.Lim YJ, Hong SJ. What is the best strategy for successful bowel preparation under special conditions? World J Gastroenterol. 2014;20(11):2741–2745. https://doi.org/10.3748/wjg.v20.i11.2741.Lim YJ, Hong SJ. What is the best strategy for successful bowel preparation under special conditions? World J Gastroenterol. 2014;20(11):2741–2745. https://doi.org/10.3748/wjg.v20.i11.2741.De Miranda Neto AA, de Moura DTH, Hathorn KE, Tustumi F, de Moura EGH, Ribeiro IB. Efficacy and Patient Tolerability of Split-Dose Sodium Picosulfate/Magnesium Citrate (SPMC) Oral Solution Compared to the Polyethylene Glycol (PEG) Solution for Bowel Preparation in Outpatient Colonoscopy: An Evidence-Based Review. Clin Exp Gastroenterol. 2020;13:449–457. https://doi.org/10.2147/CEG.S237649.De Miranda Neto AA, de Moura DTH, Hathorn KE, Tustumi F, de Moura EGH, Ribeiro IB. Efficacy and Patient Tolerability of Split-Dose Sodium Picosulfate/Magnesium Citrate (SPMC) Oral Solution Compared to the Polyethylene Glycol (PEG) Solution for Bowel Preparation in Outpatient Colonoscopy: An Evidence-Based Review. Clin Exp Gastroenterol. 2020;13:449–457. https://doi.org/10.2147/CEG.S237649.Матвеев ИА, Липовой СВ, Козлов МП, Поварнин НН. Пикосульфат натрия в клинической практике хирурга. Амбулаторная хирургия. 2023;20(2):135–143. https://doi.org/10.21518/akh2023-016.Matveev IA, Lipovoy SV, Kozlov MP, Povarnin NN. Sodium picosulfate in the clinical practice of a surgeon. Ambulatornaya Khirurgiya. 2023;20(2):135–143. (In Russ.) https://doi.org/10.21518/akh2023-016.Трухан ДИ, Деговцов ЕН, Карасев ВЕ. Послеоперационный илеус в абдоминальной хирургии: в поиске решения актуальной проблемы. Экспериментальная и клиническая гастроэнтерология. 2023;(6):89–99. https://doi.org/10.31146/1682-8658-ecg-214-6-89-99.Trukhan DI, Degovtsov EN, Karasev VE. Postoperative ileus in abdominal surgery: in search for a solution to a current problem. Experimental and Clinical Gastroenterology. 2023;(6):89–99. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-214-6-89-99.Müller-Lissner S. Constipation – pathophysiology, diagnostics, treatment. Dtsch Med Wochenschr. 2019;144(16):1145–1157. https://doi.org/10.1055/a-0670-5209.Müller-Lissner S. Constipation – pathophysiology, diagnostics, treatment. Dtsch Med Wochenschr. 2019;144(16):1145–1157. https://doi.org/10.1055/a-0670-5209.Diebakate-Scordamaglia L, Voican CS, Perlemuter G. Iatrogenic constipation in gastrointestinal surgery. J Visc Surg. 2022;159 (1 Suppl.):S51–S57. https://doi.org/10.1016/j.jviscsurg.2021.12.003.Diebakate-Scordamaglia L, Voican CS, Perlemuter G. Iatrogenic constipation in gastrointestinal surgery. J Visc Surg. 2022;159 (1 Suppl.):S51–S57. https://doi.org/10.1016/j.jviscsurg.2021.12.003.Afshar S, Kelly SB, Seymour K, Woodcock S, Werner AD, Mathers JC. The Effects of Bariatric Procedures on Bowel Habit. Obes Surg. 2016;26(10):2348–2354. https://doi.org/10.1007/s11695-016-2100-9.Afshar S, Kelly SB, Seymour K, Woodcock S, Werner AD, Mathers JC. The Effects of Bariatric Procedures on Bowel Habit. Obes Surg. 2016;26(10):2348–2354. https://doi.org/10.1007/s11695-016-2100-9.Potoczna N, Harfmann S, Steffen R, Briggs R, Bieri N, Horber FF. Bowel habits after bariatric surgery. Obes Surg. 2008;18(10):1287–1296. https://doi.org/10.1007/s11695-008-9456-4.Potoczna N, Harfmann S, Steffen R, Briggs R, Bieri N, Horber FF. Bowel habits after bariatric surgery. Obes Surg. 2008;18(10):1287–1296. https://doi.org/10.1007/s11695-008-9456-4.Crain N, Tejirian T. An Analysis of Early Postoperative Returns after Inguinal Hernia Surgery. Am Surg. 2018;84(10):1613–1616. Available at: https://pubmed.ncbi.nlm.nih.gov/30747680/.Crain N, Tejirian T. An Analysis of Early Postoperative Returns after Inguinal Hernia Surgery. Am Surg. 2018;84(10):1613–1616. Available at: https://pubmed.ncbi.nlm.nih.gov/30747680/.Wilhelm W, Vassiliadis N, Röhrig S, Eberhart LH, Görtz G. Optimization of perioperative management inlaparoscopic hernioplasty. Anaesthesist. 2008;57(9):915–925. https://doi.org/10.1007/s00101-008-1402-2.Wilhelm W, Vassiliadis N, Röhrig S, Eberhart LH, Görtz G. Optimization of perioperative management inlaparoscopic hernioplasty. Anaesthesist. 2008;57(9):915–925. https://doi.org/10.1007/s00101-008-1402-2.Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG. Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane Database Syst Rev. 2016;(8):CD009118. https://doi.org/10.1002/14651858.CD009118.pub3.Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG. Osmotic and stimulant laxatives for the management of childhood constipation. Cochrane Database Syst Rev. 2016;(8):CD009118. https://doi.org/10.1002/14651858.CD009118.pub3.Ford AC, Suares NC. Effect oflaxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and metaanalysis. Gut. 2011;60(2):209–218. https://doi.org/10.1136/gut.2010.227132.Ford AC, Suares NC. Effect oflaxatives and pharmacological therapies in chronic idiopathic constipation: systematic review and metaanalysis. Gut. 2011;60(2):209–218. https://doi.org/10.1136/gut.2010.227132.Cash BD, Lacy BE. Systematic review: FDA-approved prescription medications for adults with constipation. Gastroenterol Hepatol. 2006;2(10):736–749. Available at: https://pubmed.ncbi.nlm.nih.gov/28325992/.Cash BD, Lacy BE. Systematic review: FDA-approved prescription medications for adults with constipation. Gastroenterol Hepatol. 2006;2(10):736–749. Available at: https://pubmed.ncbi.nlm.nih.gov/28325992/.Плотникова ЕЮ, Золотухина ВН, Грачева ТЮ. Место стимулирующих слабительных средств в терапии запоров. Медицинский совет. 2016;(17):100–105. https://doi.org/10.21518/2079-701X-2016-17-100-105.Plotnikova EY, Zolotukhina VN, Gracheva ТY. Place of stimulating laxatives in therapy of constipations. Meditsinskiy Sovet. 2016;(17):100–105. (In Russ.) https://doi.org/10.21518/2079-701X-2016-17-100-105.Плотникова ЕЮ, Краснов КА. Запоры нужно лечить. Медицинский совет. 2018;(14):61–66. https://doi.org/10.21518/2079-701X-2018-14-61-66.Plotnikova EY, Krasnov KA. Сonstipation needs to be treated. Meditsinskiy Sovet. 2018;(14):61–66. (In Russ.) https://doi.org/10.21518/2079-701X-2018-14-61-66.Wulkow R, Vix JM, Schuijt C, Peil H, Kamm MA, Jordan C. Randomised, placebo-controlled, double-blind study to investigate the efficacy and safety of the acute use of sodium picosulphate in patients with chronic constipation. Int J Clin Pract. 2007;61(6):944–950. https://doi.org/10.1111/j.1742-1241.2007.01374.x.Wulkow R, Vix JM, Schuijt C, Peil H, Kamm MA, Jordan C. Randomised, placebo-controlled, double-blind study to investigate the efficacy and safety of the acute use of sodium picosulphate in patients with chronic constipation. Int J Clin Pract. 2007;61(6):944–950. https://doi.org/10.1111/j.1742-1241.2007.01374.x.Mueller-Lissner S, Kamm MA, Wald A, Hinkel U, Koehler U, Richter E, Bubeck J. Multicenter, 4-week, double-blind, randomized, placebocontrolled trial of sodium picosulfate in patients with chronic constipation. Am J Gastroenterol. 2010;105(4):897–903. https://doi.org/10.1038/ajg.2010.41.Mueller-Lissner S, Kamm MA, Wald A, Hinkel U, Koehler U, Richter E, Bubeck J. Multicenter, 4-week, double-blind, randomized, placebocontrolled trial of sodium picosulfate in patients with chronic constipation. Am J Gastroenterol. 2010;105(4):897–903. https://doi.org/10.1038/ajg.2010.41.Kienzle-Horn S, Vix JM, Schuijt C, Peil H, Jordan CC, Kamm MA.Comparison of bisacodyl and sodium picosulphate in the treatment of chronic constipation. Curr Med Res Opin. 2007;23(4):691–699. https://doi.org/10.1185/030079907x178865.Kienzle-Horn S, Vix JM, Schuijt C, Peil H, Jordan CC, Kamm MA.Comparison of bisacodyl and sodium picosulphate in the treatment of chronic constipation. Curr Med Res Opin. 2007;23(4):691–699. https://doi.org/10.1185/030079907x178865.Дроздов ВН, Карноух КИ, Сереброва СЮ, Комиссаренко ИА, Стародубцев АК. Возможности применения натрия пикосульфата в фармакотерапии запоров при функциональных расстройствах кишечника. Медицинский совет. 2019;(3):92–97. https://doi.org/10.21518/2079-701X-2019-3-92-97.Drozdov VN, Karnouh KI, Serebrova SY, Komissarenko IA, Starodubtsev AK. Possibilities of sodium picosulfate application in constipation pharmacotherapy in functional intestinal disorders. Meditsinskiy Sovet. 2019;(3):92–97. (In Russ.) https://doi.org/10.21518/2079701X2019-3-92-97.Bengtsson M, Ohlsson B. Retrospective study of long-term treatment with sodium picosulfate. Eur J Gastroenterol Hepatol. 2004;16(4):433–434. https://doi.org/10.1097/00042737-200404000-00014.Bengtsson M, Ohlsson B. Retrospective study of long-term treatment with sodium picosulfate. Eur J Gastroenterol Hepatol. 2004;16(4):433–434. https://doi.org/10.1097/00042737-200404000-00014.Bengtsson M, Ohlsson B. Psychological well-being and symptoms in women with chronic constipation treated with sodium picosulphate. Gastroenterol Nurs. 2005;28(1):3–12. https://doi.org/10.1097/00001610-200501000-00002.Bengtsson M, Ohlsson B. Psychological well-being and symptoms in women with chronic constipation treated with sodium picosulphate. Gastroenterol Nurs. 2005;28(1):3–12. https://doi.org/10.1097/00001610-200501000-00002.Rao SSC, Brenner DM. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. Am J Gastroenterol. 2021;116(6):1156–1181. https://doi.org/10.14309/ajg.0000000000001222.Rao SSC, Brenner DM. Efficacy and Safety of Over-the-Counter Therapies for Chronic Constipation: An Updated Systematic Review. Am J Gastroenterol. 2021;116(6):1156–1181. https://doi.org/10.14309/ajg.0000000000001222.Rao SSC, Brenner DM. Evidence-based treatment recommendations for OTC management of chronic constipation. J Am Assoc Nurse Pract. 2022;34(9):1041–1044. https://doi.org/10.1097/JXX.0000000000000760.Rao SSC, Brenner DM. Evidence-based treatment recommendations for OTC management of chronic constipation. J Am Assoc Nurse Pract. 2022;34(9):1041–1044. https://doi.org/10.1097/JXX.0000000000000760.Luthra P, Camilleri M, Burr NE, Quigley EMM, Black CJ, Ford AC. Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2019;4(11):831–844. https://doi.org/10.1016/S2468-1253(19)30246-8.Luthra P, Camilleri M, Burr NE, Quigley EMM, Black CJ, Ford AC. Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2019;4(11):831–844. https://doi.org/10.1016/S2468-1253(19)30246-8.Tan S, Zhang W, Zeng P, Yang Y, Chen S, Li Y et al. Clinical effects of chemical drugs, fecal microbiota transplantation, probiotics, dietary fiber, and acupuncture in the treatment of chronic functional constipation: a systematic review and network meta-analysis. Eur J Gastroenterol Hepatol. 2024;36(7):815–830. https://doi.org/10.1097/MEG.0000000000002786.Tan S, Zhang W, Zeng P, Yang Y, Chen S, Li Y et al. Clinical effects of chemical drugs, fecal microbiota transplantation, probiotics, dietary fiber, and acupuncture in the treatment of chronic functional constipation: a systematic review and network meta-analysis. Eur J Gastroenterol Hepatol. 2024;36(7):815–830. https://doi.org/10.1097/MEG.0000000000002786.Chang L, Chey WD, Imdad A, Almario CV, Bharucha AE, Diem S et al. American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation. Gastroenterology. 2023;164(7):1086–1106. https://doi.org/10.1053/j.gastro.2023.03.214.Chang L, Chey WD, Imdad A, Almario CV, Bharucha AE, Diem S et al. American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation. Gastroenterology. 2023;164(7):1086–1106. https://doi.org/10.1053/j.gastro.2023.03.214.Rossol S. Constipation in patients with diabetes mellitus. MMW Fortschr Med. 2007;149(44):39–42. https://doi.org/10.1007/bf03365174.Rossol S. Constipation in patients with diabetes mellitus. MMW Fortschr Med. 2007;149(44):39–42. https://doi.org/10.1007/bf03365174.Prasad VG, Abraham P. Management of chronic constipation in patients with diabetes mellitus. Indian J Gastroenterol. 2017;36(1):11–22. https://doi.org/10.1007/s12664-016-0724-2.Prasad VG, Abraham P. Management of chronic constipation in patients with diabetes mellitus. Indian J Gastroenterol. 2017;36(1):11–22. https://doi.org/10.1007/s12664-016-0724-2.Сас ЕИ, Гриневич ВБ. Сложный пациент. Ведение больных с резистентными запорами. Медицинский совет. 2019;(14):88–92. https://doi.org/10.21518/2079-701X-2019-14-88-92.Sas EI, Grinevich VB. Difficult patient. Management of resistant constipation. Meditsinskiy Sovet. 2019;(14):88–92. (In Russ.) https://doi.org/10.21518/2079-701X-2019-14-88-92.Müller-Lissner S. Constipation – pathophysiology, diagnostics, treatment. Dtsch Med Wochenschr. 2019;144(16):1145–1157. https://doi.org/10.1055/a-0670-5209.Müller-Lissner S. Constipation – pathophysiology, diagnostics, treatment. Dtsch Med Wochenschr. 2019;144(16):1145–1157. https://doi.org/10.1055/a-0670-5209.Bader S, Weber M, Becker G. Is the pharmacological treatment of constipation in palliative care evidence based? Schmerz. 2012;26(5):568–586. https://doi.org/10.1007/s00482-012-1246-1.Bader S, Weber M, Becker G. Is the pharmacological treatment of constipation in palliative care evidence based? Schmerz. 2012;26(5):568–586. https://doi.org/10.1007/s00482-012-1246-1.Jarlbæk L, Johnsen B, Hansen OB, Hedal B. Treatment of constipation in palliative care patients is a challenge. Ugeskr Laeger. 2016;178(33):V03160218. Available at: https://pubmed.ncbi.nlm.nih.gov/27550785/.Jarlbæk L, Johnsen B, Hansen OB, Hedal B. Treatment of constipation in palliative care patients is a challenge. Ugeskr Laeger. 2016;178(33):V03160218. Available at: https://pubmed.ncbi.nlm.nih.gov/27550785/.Friedrich C, Richter E, Trommeshauser D, de Kruif S, van Iersel T, Mandel K, Gessner U. Absence of excretion of the active moiety of bisacodyl and sodium picosulfate into human breast milk: an open-label, parallel-group, multiple-dose study in healthy lactating women. Drug Metab Pharmacokinet. 2011;26(5):458–464. https://doi.org/10.2133/dmpk.dmpk-11-rg-007.Friedrich C, Richter E, Trommeshauser D, de Kruif S, van Iersel T, Mandel K, Gessner U. Absence of excretion of the active moiety of bisacodyl and sodium picosulfate into human breast milk: an open-label, parallel-group, multiple-dose study in healthy lactating women. Drug Metab Pharmacokinet. 2011;26(5):458–464. https://doi.org/10.2133/dmpk.dmpk-11-rg-007.Alsalimy N, Madi L, Awaisu A. Efficacy and safety oflaxatives for chronic constipation inlong-term care settings: A systematic review. J Clin Pharm Ther. 2018;43(5):595–605. https://doi.org/10.1111/jcpt.12721.Alsalimy N, Madi L, Awaisu A. Efficacy and safety oflaxatives for chronic constipation inlong-term care settings: A systematic review. J Clin Pharm Ther. 2018;43(5):595–605. https://doi.org/10.1111/jcpt.12721.Noergaard M, Traerup Andersen J, Jimenez-Solem E, Bring Christensen M. Long term treatment with stimulant laxatives – clinical evidence for effectiveness and safety? Scand J Gastroenterol. 2019;54(1):27–34. https://doi.org/10.1080/00365521.2018.1563806.Noergaard M, Traerup Andersen J, Jimenez-Solem E, Bring Christensen M. Long term treatment with stimulant laxatives – clinical evidence for effectiveness and safety? Scand J Gastroenterol. 2019;54(1):27–34. https://doi.org/10.1080/00365521.2018.1563806.Whorwell P, Lange R, Scarpignato C. Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge. Therap Adv Gastroenterol. 2024;17:17562848241249664. https://doi.org/10.1177/17562848241249664.Whorwell P, Lange R, Scarpignato C. Review article: do stimulant laxatives damage the gut? A critical analysis of current knowledge. Therap Adv Gastroenterol. 2024;17:17562848241249664. https://doi.org/10.1177/17562848241249664.Скворцов ВВ, Скворцова ЕМ, Байманкулов СС. Современная тактика лечения запоров. Медицинский совет. 2019;(21):148–153. https://doi.org/10.21518/2079-701X-2019-21-148-153.Skvortsov VV, Skvortsova EM, Baimankulov SS. Modern tactics of treatment of constipation. Meditsinskiy Sovet. 2019;(21):148–153. (In Russ.) https://doi.org/10.21518/2079-701X-2019-21-148-153.Ардатская МД, Буторова ЛИ, Анучкин АА, Гайворонский ИН, Павлов АИ, Паценко ОЮ. Хронический запор: современные возможности патогенетической терапии. Медицинский совет. 2024;18(8):145–153. https://doi.org/10.21518/ms2024-181.Ardatskaya MD, Butorova LI, Anuchkin AA, Gaivoronsky IN, Pavlov AI, Patsenko OYu. Chronic constipation: current options of pathogenetic therapy. Meditsinskiy Sovet. 2024;18(8):145–153. (In Russ.) https://doi.org/10.21518/ms2024-181.Бехтерева МК, Богданова НМ. Постинфекционные гастроинтестинальные расстройства и возможности их коррекции. Медицинский совет. 2024;18(11):84–91. https://doi.org/10.21518/ms2024-217.Bekhtereva MK, Bogdanova NM. Post-infection gastrointestinal disorders and treatment options. Meditsinskiy Sovet. 2024;18(11):84–91. (In Russ.) https://doi.org/10.21518/ms2024-217.Шемеровский КА. Что надо знать, чтобы запором не страдать. Амбулаторная хирургия. 2020;(3-4):102–107. https://doi.org/10.21518/1995-1477-2020-3-4-102-107.Shemerovskii KA. What you need to know to avoid constipation. Ambulatornaya Khirurgiya. 2020;(3-4):102–107. (In Russ.) https://doi.org/10.21518/1995-1477-2020-3-4-102-107.Белоус СС, Абрицова МВ, Торчуа НР, Богданова ЕМ. Использование пикосульфата натрия в лечении геморроя. Амбулаторная хирургия. 2023;20(1):133–139. https://doi.org/10.21518/akh2023-006.Belous SS, Abritsova MV, Torchua NR, Bogdanova EM. The use of sodium thiosulfate in the treatment of hemorrhoids. Ambulatornaya Khirurgiya. 2023;20(1):133–139. (In Russ.) https://doi.org/10.21518/akh2023-006.Лазарева ЮА, Егоров ДВ, Селивёрстов ПВ. Функциональный запор у пациентов с травмой опорно-двигательного аппарата. Медицинский совет. 2023;17(8):182–187. https://doi.org/10.21518/ms2023-126.Lazareva YA, Egorov DV, Seliverstov PV. Functional constipation in patients with injuries of the musculoskeletal system. Meditsinskiy Sovet. 2023;17(8):182–187. (In Russ.) https://doi.org/10.21518/ms2023-126.

The authors declare that there are no conflicts of interest present.