@article{oai:tohoku-mpu.repo.nii.ac.jp:00000791,
 author = {関根, 僚也 and Sekine, Ryoya and 高橋, 将典 and Takahashi, Masanori and 薄井, 健介 and Usui, Kensuke and 岡田, 浩司 and Okada, Kouji and 小暮, 高之 and Kogure, Takayuki and 佐藤, 賢一 and Satoh, Kennichi and 久下, 周佐 and Kuge, Shusuke and 渡辺, 善照 and Watanabe, Yoshiteru},
 issue = {66},
 journal = {東北医科薬科大学研究誌, Journal of Tohoku Medical and Pharmaceutical University},
 month = {Dec},
 note = {Hepatic encephalopathy is often seen in patients with chronic liver disease. It is prognosis after onset is poor, and it is associated with significant mortality. In addition, it has a strong relationship with constipation, and,defecation management is important. Currently, the European Association for the Study of Liver and American Association for Study of Liver Diseases guidelines for the treatment of chronic liver disease hepatic encephalopathy recommend two to three defecations per day. However, frequent defecation is a burden on patients. in Japan, rifaximin, a non-absorbable antibacterial drug, was recently launched. As a result, the treatment of hepatic encephalopathy, which mainly involves lactulose, has been reviewed. in this case, the effect of combined use of rifaximin and a laxative against hepatic encephalopathy ware examined by evaluating intestinal peristalsis using astethoscope. This treatment prevented hepatic encephalopathy in the current case, despite the patient only  defecating once a day. This approach was considered to be effective because the combined use of rifaximin suppressed the increase in the patient s blood ammonia concentration. In addition, the continuous recording of the patient s intestinal peristaltic sound confirmed that the risk of constipation had not increase although there had been no loss of intestinal peristaltic movement. These results suggest that the defecation management based on physical examinations conducted by pharmacist might be useful for assessing the risk of complications and quality of life issues in patient with chronic liver disease.},
 pages = {75--82},
 title = {【症例報告】非代償性肝硬変患者に対してリファキシミンと複数の瀉下薬使用により肝性脳症の回避を試みた一例～薬剤師による継続的なフィジカルアセスメントを通した排便コントロール～},
 year = {2019},
 yomi = {セキネ, リョウヤ and タカハシ, マサノリ and ウスイ, ケンスケ and オカダ, コウジ and コグレ, タカユキ and サトウ, ケンイチ and クゲ, シュウスケ and ワタナベ, ヨシテル}
}