Constipation is a delay in the emptying of the intestine for more than forty-eight hours. The most common constipation occurs in young children and elderly people. Practically all people have constipations throughout their life. They can appear after operations, stress, travel and arise due to the stress of the body, but since such disorders very quickly pass after the person returns to his habitual way of life, this is not considered a disease. Russian gastroenterologists attribute constipation to the symptom of the underlying disease. However, in the event that they begin to recur frequently enough and become habitual, a compulsory medical consultation with subsequent mandatory appointment of treatment. Constipation is a serious medical, as well as a social problem
Symptoms of constipation
For constipation, a small amount of feces, increased hardness, dryness, sensation after defecation, not complete evacuation of the intestine. Changing the rhythm and frequency of the stool also indicates a symptom. The presence of at least one of the signs suggests a symptom of constipation. At the same time, many people consider themselves to be sick in the absence of daily defecation. This is a misconception.
The consistency of feces is characterized by the amount of water. For example, in solid feces the amount of water is up to 40%, in normal feces up to 70% and in liquid feces up to 95% of water. The criterion of constipation is usually considered to be a stool mass of less than 35 grams per day. The clinical picture is supplemented by a very difficult defecation, as well as discomfort in the abdomen. The patient's complaints themselves depend on a number of subjective factors and the duration of the underlying disease
), которые сопровождаются выраженными болевыми ощущениями и препятствуют нормальному опорожнению кишечника - Diseases of the anus (paraproctitis, anal fissure, hemorrhoids ), which are accompanied by severe pain and prevent normal emptying of the intestine
- Irrational nutrition, poor in plant fibers, which is combined with a small amount of fluid intake and sedentary lifestyle
- Large accumulations in the intestine of hardened stool masses - the so-called "stool stones"
- Endocrine diseases (diabetes, hypothyroidism, etc.)
- Neurological diseases (multiple sclerosis, Parkinson's disease, stroke, tumors and various spinal cord injuries)
- Reception of some kinds of medical products (diamonds, baking soda, atropine, etc.)
- Hypotension of muscles (age-related patients - senile constipation). People of age suffer from slow fecal movement through the large intestine
Promotion of stool as a result of constipation is very rapidly slowed down, due to the appearance of any obstacle in their path, or as a result of the impaired function of shrinking intestinal walls
In most cases, the symptoms depend on the nature of the constipation that caused constipation. The most common symptoms are:
- Bloating and a feeling of heaviness in the stomach (may be accompanied by rapid heartbeat)
- Dense painful stool (feces can be bean-shaped, spherical, ribbon-shaped, in the form of dry dense balls)
- In the anal passage, the formation of blood cracks
- Meteorisms (due to increased gas generation)
- There is an unpleasant aftertaste in the mouth, a belch and an appetite decreases
- There are headaches and muscle pains, there is insomnia and nervousness
According to the nature of the leakage, constipation is acute, as well as chronic. Acute occur in a short time and are provoked by different causes, but acute constipation, if ignored, can become chronic.
Acute constipation is characterized by a lack of stool for several days. The cause is intestinal obstruction due to a tumor (mechanical obstruction), and also possible inflammation in the abdominal cavity (obstruction dynamic), and if in the intestine, it is diverticulitis or disease in the anorectal region. An unexpected lack of stools is observed after an overdose of drugs, craniocerebral trauma, in bedridden patients. If there is no stool, and also gases do not escape, then intestinal obstruction is presumably developing. With the growth of acute constipation (two weeks), probably a lesion with a large intestine tumor.
Chronic constipation is dangerous with prolapse of the rectum, because of the constant need to push. Also, chronic constipation can be accompanied by skin changes - it loses its elasticity, becomes flabby and pale, sometimes with a yellowish tinge.
In chronic colitis, constipation occurs in every second patient, and for enteritis, one in five.
Prolonged constipation increases the risk of developing such diseases: diverticulosis of the intestine, inflammation and fissures of the rectum, hemorrhoids and cancer of the colon or rectum
Types of constipation
Constipation is given depending on the etiology:
- Conditionally reflex neurogenic caused by the situation
- functional, arising due to irritated colon
- constipation, formed with organic pathology of the intestine due to neoplasms, diverticulum, ischemia, stenosis
- Constipation caused by neuromuscular disorders in the intestine due to multiple sclerosis, neuromatosis, systemic scleroderma, amyloidosis
- Constipation (dyshexia), caused by pathology in the rectal, as well as the anal region due to cracks, fistulas, rectocele, abscesses, strictures, viral or syphilitic condylomas
- symptomatic constipation
- constipation caused by endocrine pathology in diabetes mellitus, hypothyroidism
- constipation caused by neurological pathology in Parkinson's disease, spinal cord injury and organic pathology of the central nervous system
- constipation caused by inflammation in the organs of the urogenital sphere
- drug-induced constipation associated with the use of psychotropic drugs such as clonidine, calcium antagonists, cholinolytics, narcotic analgesics, tranquilizers, antidepressants, antiparkinsonics, antacids, tricyclic antidepressants, nonsteroidal anti-inflammatory drugs, iron preparations, sympathomimetics, lithium and bismuth drugs, diuretics, barbiturates , phenothiazines, barium sulfate, iron preparations
The main direction of treatment of constipation is the normalization of motor function of the intestine. It includes:
- Increased physical activity (exercise and walking are the most effective means of treating constipation)
- Cleansing and medicinal enemas (oil: with fish oil, olive or sunflower oil, etc.). With a cleansing enema, the water temperature is used indoors, a little salt is added. It is possible to use microclysters, which are sold in pharmacies. But it is important to remember that resorting constantly to the help of enemas there is an addictive organism
- Compulsory diet, including products rich in vegetable fiber (vegetables, greens, coarse black bread, fruits, food bran, cereals, honey, sour-milk products). The daily rate of fluid intake should be at least two liters per day. The food should be regular, in frequency - at least five times a day. The following foods should be avoided: cheese, milk, fried foods, beans, cabbage and cauliflower, red meat. It is recommended to eat strictly according to the regime
- In case of admission, it is necessary to cancel the drugs, the reception of which leads to a weakening of the bowel contraction (almugel, atropine, baking soda, some types of antidepressants)
- Reception of laxatives and funds (Seine, Bisacodil, Dufalac). It is important to know that over time, there is an addiction to laxatives and the sufferer is forced to increase the dose. In cases where a change in the nature and enrichment of the diet does not lead to the desired result - prescribe drugs lactulose (such as Dufalac, etc.)
- Velocity of massage on the anterior abdominal wall in the treatment of constipation. Massage with constipation depends on the tasks assigned and in connection with this distinguish: segmental-reflex, point, hardware, therapeutic self-massage
Segmental reflex massage of the abdomen is carried out for reflex action on all internal organs.
Acupressure of the abdomen is carried out in a relaxing, as well as stimulating way on all biologically active zones (points). At the heart of acupressure is the principle of the method of acupuncture, but instead of needles on the biological points are affected by a finger, and also by a brush. There are 700 biological points, but more often up to 150 are used. The point massage mechanism is based on biologically active points. In the morning before work this type of massage is very effective for prevention and treatment. We spend it lying or sitting. A good alternative in the case if there is nobody to do the massage and self-massage is a point massage. Acupressure or self-massage increases blood supply, reduces soreness, and also reduces nervous and muscle tension.
The apparatus massage of the abdomen with constipation is performed by ultrasonic, vibration, and ionizing devices.
The therapeutic self-massage with constipation is performed by the patient himself at a convenient time, but half an hour after breakfast and two hours after lunch. The technique of self-massage of a stomach includes the maximal relaxation lying on a back. Your hands should be clean, warm; If desired, bare the stomach or through cotton underwear begin simple stroking strokes. Your actions should be directed along the movement of the lymph current, clockwise. Delicate movements from the right iliac region are directed to the right subcostal region, and then descend to the left ileal region. Reception stroking replaces the circular, as well as spiraling rubbing alternating with pressure and vibration
- Surgical treatment of constipation begins with the presence of mechanical constipation, when they are accompanied by tumors, diverticula, strictures
Necessarily observance of a diet. It is necessary to refrain from eating dried fruits, most beans, salads, cold dishes and drinks. And on the contrary, give preference to warm dishes and drinks, eat boiled vegetables, fresh fruit (apples, bananas, peaches), raisins, pineapple juice, prunes. It is also necessary to regularly eat vegetable oil in small quantities. It is recommended to change the pace of life to a more dynamic, do not neglect physical exercise and walking.