According to statistics, every second person at least once in his life has experienced such a nuisance as constipation. To understand the concept of “constipation”, it is necessary to know how the large intestine functions normally.
Most people (about two thirds) are emptied daily. A fifth of the entire population of the Earth visits the toilet “for serious affairs” twice a day, and the remaining people – about three times a day. So what is considered normal?
If defecation occurs from three times a day to three times in seven days – this is normal. About constipation should be said when the stool is delayed for more than 48 hours, the defecation itself is painful, the volume of feces does not exceed 100 grams, and they are very dense.
Constipation are divided into functional and organic. In addition, this disease can be acute and chronic.
With an increased intestinal tone, when its individual parts spasm , the fecal masses are forced to “get stuck” in them and cannot get into the rectum. In this case, talking about spastic constipation. If intestinal motility is weakened, then the food lump (chyme) hardly moves along it, which indicates atonic constipation.
Depending on the reason that caused this condition, the following types of constipation are known:
- alimentary (errors in nutrition);
- hypokinetic (sedentary lifestyle);
- reflex (diseases of the gastrointestinal tract: pancreatitis, gastritis and others);
- toxic (permanent poisoning of the body with various toxic substances, including drugs);
- endocrine (diseases of the endocrine system);
- mechanical (obstruction in the colon: tumors, scars, etc.);
- neurogenic or psychogenic (pathology of the nervous system or psychological problems).
First of all, the cause of constipation is improper nutrition:
- constant snacks;
- failure to comply with the regime;
- lack of fluid in the diet;
- neglect of fiber;
- insufficient amount of dairy products in the daily menu.
The way of life also affects the intestinal work: hypodynamia associated with the peculiarities of the profession, or forced immobility in long-term bedridden patients contribute to constipation.
Do not forget about chronic diseases of the digestive tract, the presence of formations in the intestines, scars and endocrine diseases (pathology of the thyroid gland, diabetes and others) that may interfere with normal emptying.
Smoking, drug addiction or harmful production factors are also causes of the disease. Perhaps the development of constipation on the background of drug abuse (antispasmodics, sedatives).
Separately, it is necessary to identify the causes of psychogenic constipation. A person is able to constantly suppress defecation due to objective reasons:
- it is impossible to leave the place of work, study;
- inability to use the public toilet;
- traveler’s constipation, when people cannot empty their intestines in traveling conditions;
- and others.
Mental injury is also a factor that can trigger constipation.
The clinical picture of atonic and spastic constipation is different.
Signs of Atonic Constipation
With atonic constipation, the patient is worried about:
- feeling of fullness in the stomach;
- feeling of pain in the abdomen;
- pain whining character.
The stool during defecation is at first dense and abundant, have a certain shape, and at the end of the process they become semi-shaped. The patient experiences pain during stool, it takes a lot of effort to empty. Strong straining leads to damage to the rectal mucosa, which leads to the formation of cracks . In this regard, on toilet paper and even on the surface of feces you can see blood.
Signs of spastic constipation
In spastic constipation, the patient complains of:
- abdominal pains of the type of colic;
- flatulence .
Fecal masses are insignificant and look like sheep feces. During defecation, a person is not inconvenienced, and there is no signs of blood in feces or on toilet paper.
Prolonged constipation leads to intoxication of the body due to the absorption of toxic substances, which were formed in the process of metabolism. The patient becomes lethargic, gets tired quickly, his sleep and emotional state are disturbed. Intoxication of this kind is characterized by irritability and nervousness of the patient.
Constipation during pregnancy is not uncommon, they suffer up to 70% of expectant mothers. The causes of the disease are reduced to changes in the body:
- during the period of gestation, hormonal changes;
- production increases progesterone, which not only relaxes the uterine muscles, but also weakens intestinal motility;
- A growing uterus affects the occurrence of problems with emptying: the longer the gestation, the more it squeezes the intestines.
A sedentary lifestyle, due to the physical condition of pregnant women, also contributes to constipation.
Expectant mothers should monitor the bowels and fight the problem. Long-term constipation is a risk factor preterm birth, it provokes the occurrence hemorrhoids and purulent-septic complications in the postpartum period.
To diagnose constipation, the doctor collects the patient’s complaints, examines it, and prescribes laboratory research methods: general blood and urine tests.
In addition, it is shown irrigoscopy (X-ray examination of the intestines) and colonoscopy (examination of the intestinal endoscope). Irrigoscopy and colonoscopy allow you to establish how the intestines function, whether there are tumors, scars, inflammation or ulceration.
In some cases, consultations with a neurologist and endocrinologist are indicated.
The proctologist and the gastroenterologist deal with constipation.
First of all, for complete recovery should change the nature of power. Assigned to a special diet, which includes the use of:
- a large amount of fiber (fresh vegetables and fruits, bran, buckwheat, etc.);
- fermented milk products;
- fluid at least 1.5-2 liters per day.
It is also necessary to revise the lifestyle and expand physical activity through physical education and sports exercises.
If constipation resulted in any pathology of the gastrointestinal tract or the endocrine system, treatment is directed at the underlying disease.
Treatment of Atonic Constipation
When atonic constipation (weakened peristalsis) prescribe drugs that irritate the intestinal wall, thereby stimulating peristalsis. Typically, this means, which include senna ( regulaks, senade, kafiol ) and bisacodyl ( guttalaks, pyrilax, bisadil ). The course of therapy with these drugs is short: no more than 10 days, so as not to cause addiction.
Probiotics based on lactulose ( macrogol ) are safer, they have a stimulating effect on the intestinal flora, accelerate its growth and increase the volume of fecal masses. This may be Duphalac , Goodluck or Poslabin .
Spastic constipation treatment
Spastic constipation is not treated with laxatives, but with antispasmodics (no-spa, papaverine). In addition, it shows the reception of warm baths, massage of the abdomen, light sedatives. Enzymatic agents are also prescribed ( panzinorm , festal ).
In case of acute constipation, cleansing enemas can be used, but not often.
The prognosis for constipation is usually favorable. However, this condition may be complicated by the formation of fecal stones, intestinal obstruction and fecal peritonitis . This is especially true of the elderly and paralyzed patients.