What is constipation

Constipation is considered to be no bowel movement for 2 or more days. Some gastroenterologists insist on an individual physiological mode of bowel evacuation, believe that for some people, liberation from stool masses every 4-6 days can be the norm. It is important that a person does not experience discomfort.

Complaints have estimated that constipation occurs in 40% of the population. They are more inclined to women and elderly people. Whichever doctor the patient addresses, he will be given a checkup. To recommend treatment, it is necessary to identify the causes of constipation. Symptoms of failure of defecation need to be told without embarrassment, because constipation causes different diseases. This will help the doctor to assume a connection with the diet or pathology of the body.

Signs of

When the bowel is irregularly emptied, a person feels:

• constant bloating( flatulence);
• belching;
• severity in the epigastric region and around the navel;
• smack of bitterness in the mouth;
• pain in the anus opens in connection with cracks and hemorrhoids;
• lack of appetite;
• painful defecation.

Prolonged course of the disease leads to the phenomena of intestinal intoxication - headache, insomnia, increased irritability, tearfulness, depression. Close people notice that the mood of the patient depends on how successfully he went to the toilet.

The left half of the stomach is swelling

Depending on the mechanism of dysfunction of the muscles of the intestine, clinicians distinguish between spastic and atonic constipation. Spasm causes short-term pain along the bowel as a colic, a delay in gases. Atony - the mechanism of manifestation of severe severe constipation in the elderly. In this case there is no reaction from the intestinal wall to signals from the center. The large intestine expands, accumulates enough slag substances, creates conditions for increased fermentation and gas formation.

By nature of constipation, constipation is possible acute or chronic. Sudden prolonged stool retention often occurs in an adult person in response to an unusual diet, restrictive diet, the introduction of complementary foods for an infant, with a lack of fluids in the heat. Emptying the bowel is delayed for several days.

If you do not understand the cause of the problem or ignore the symptoms of constipation, it becomes chronic. With frequent straining, hemorrhoids form, prolapse of the rectum, bleeding from the hemorrhoidal veins. The act of defecation becomes painful. When babies suffer from constipation, the child constantly screams, tights, refuses to eat. Stool retention for 36 hours in a child up to a year is already considered a dangerous condition. Read more about constipation in children in this article.

How are the fecal masses formed and promoted through the intestine?

To understand the reasons for the delay in emptying, you need to remember the factors that affect the promotion of the contents of the small and large intestine. Feces are waste products of biochemical reactions of the body.

Some of them are poisonous in high concentrations( indole, skatole).As a result of digestion, all useful ingredients, salts, biologically active substances, water are absorbed from the intestine. Enormous digestion is provided by the intestinal flora. Thanks to beneficial bifido-, lacto and other bacteria, vitamins are formed. The remainder of the cellulose, surplus substances.

How many days you need a healthy digestive tract to completely treat the foods eaten depends on the composition. The longest "processed" animal food, consisting of fatty meat, fish. The process lasts for 2-3 days in the intestine. Lighter products are transformed into feces within 12 hours.

Waves of peristalsis are formed even in the empty intestine

Movement of the intestine to the exit provides a contraction of the circular and longitudinal muscles. For normal movements in the intestine, the following are responsible:

• impulses from the brain and spinal cord;
• presence in the intestinal wall of "prepared areas" for signal perception;
• local irritant effect of the contents;
• sufficient production of mucus;
• microorganism balance;
• necessary water supply for the formation of stool consistency.

Diagnosis of constipation should determine at what stage a stall occurred, which prevents peristalsis. It is necessary to answer the question, why does the intestine work poorly?

Causes and types of

Constipation in adults and children differ in origin. Most often, people create the conditions for stool retention by:

• "sedentary" lifestyle - when walking, abdominal muscles massage the intestines in a natural way;
• violations of quality and diet - eating dry, lack of a regular meal schedule, overeating and periods of hunger;
• use of unbalanced diets for weight loss;
• of nervous overload at work, inability to rest.

To objective factors include any diseases of the gastrointestinal tract, affecting the transport function of the intestine, pathology and the consequences of spinal cord injuries, cerebral circulation disorders. Types of constipation are distinguished by individual characteristics. By frequency of occurrence: temporary and permanent.

The formation of stony stones is typical of chronic constipation

Depending on the consistency of stool mass:

• constipation - usually the defecation delay is no longer than two days, the stool is of a non-uniform consistency, it is possible for the emptying act to incomplete removal;
• Obstapation is a more complicated form, the feces take a stone-like hardness, they are unable to leave the large intestine on their own or cause cracks and bleeding. This form requires a special choice of methods of treating constipation.

In terms of the duration of symptoms, on the basis of complaints of adults, forms are distinguished:

• acute - occurs rarely, is associated with altered feeding( on travel), sudden stressful situation, the capacity of the large intestine is temporarily disturbed and restored independently during normalization of habitual conditions of life;
• chronic - failure of emptying worries for three or more months, the frequency of defecation - every 3 days after enemas, taking laxatives.

According to the prevailing cause, constipation happens:

• situational - caused by the transferred stress;
• hypokinetic - associated with low physical activity;
• alimentary - due to the lack of eating fruits and vegetables( vegetable fiber) to stimulate peristalsis, a sufficient volume of drinking water( dilution of stool);
• mechanical - formed due to obstruction in the intestine( tumors, polyps, adhesions, scars);
• reflex - is possible with various pathologies of the stomach and intestines;
• endocrine - accompanies hormonal changes, often occurs in adolescents with a decrease in the function of the thyroid gland or ovaries, in adults - with diabetes, menopause;
• toxic - is formed in connection with the central and local effects of toxic substances, poisons( salts of mercury and lead), certain drugs, nicotine;
• neurogenic - diseases of the brain and spinal cord( trauma) break existing links, signals into the intestine are blocked;
• psychogenic - possibly associated with forced containment of defecation, uncomfortable or lack of toilet, restraint, the process looks back to diarrhea in case of agitation( "bear" disease), is diagnosed after exclusion of other causes;
• proctogenic - is distinguished by proctologists as a symptom of dysfunction of the muscles of the pelvic floor, puncture of the perineum, borne severe birth.

The causes of functional constipation in irritable bowel syndrome have not yet been clarified. It is often observed after nervous overload, stress. But neurological diseases are absent. Constipation during pregnancy, especially in the early stages can be attributed to the mechanism of mixed. In this case, an important role is played by an increased concentration of progesterone, a decrease in the habitual motor activity of a woman, a change in the nature of nutrition.

Separately account for constipation in diseases of the digestive system:

• after a previous cholecystectomy;
• for intestinal adhesions;
• for neoplasms;
• helminthic invasion in childhood;
• for abnormalities of intestinal development( dolichosigma, megacolon).

To determine the type and nature of the pathological process, only a qualified specialist

can. How do the constipations are divided into stages?

Constipation therapy involves several treatment options. Depending on the results, it is possible to judge the stage of the course of the disease.

• I( compensated) - a good effect is achieved by dietary intake, compliance with the regime, physiotherapy exercises. Constant control of the products, physical load allow you to get rid of constipation once and for all.
• II( the stage of subcompensation) - dietary nutrition is not enough, it is necessary to select medicines, treatment of the underlying disease.
• III( stage of decompensation) - severe constipation causes bleeding, prolapse of the rectum, infringement of hemorrhoids. It can not be overcome without enemas, drugs affecting the motor function of the intestine.

What kind of examination should I go through?

In the diagnosis, it is important to question the patient, find out his eating habits, the number of meals, the motor regime, the connection of stool delay with excitement. With displays it is necessary to address to the pediatrician with children, to the therapist - adults. It may be necessary to consult a neurologist, gastroenterologist.

The minimum of the examination includes blood tests, urine, coprogram( it will allow to evaluate the elements of stool constipation, the presence of intestinal bleeding, the degree of disruption of digestion of food).The method of irrigoscopy is based on the introduction of a contrast agent with an enema followed by a series of X-rays. Shows the patency of the large intestine, the presence of tumor-like formations, an abnormality of the sigmoid colon.

Colonoscopy - refers to endoscopic research. A thin tube with a camera at the end is inserted through the rectum to the patient under anesthesia. It allows you to examine the lumen of the intestine, the mucous membrane, to take material from the suspicious areas for biopsy. To determine the usefulness of the sphincter apparatus, the doctor may prescribe a sphincterometry and anorectometry.

Comparative view of unfilled and contrasted intestine

Negative effects of

Constipation is included in a group of risk factors for many diseases:

• , a high concentration of slags causes allergic reactions and auto-allergic effects to produce antibodies to one's own cells;
• skin itching, hives;
• Malignant tumors of the intestines, stomach, ovaries in women, the bladder and prostate men, pancreas;
• anemia of iron deficiency and B12-deficient origin;
• bleeding from the hemorrhoidal veins;
• dysfunction of the gonads due to beriberi;
• prone to frequent infections due to decreased immunity.

We recommend you to read about the possibilities of therapy at home in this article.

Treatment of

Regardless of the cause, treatment of constipation begins with a diet.

Therapeutic diet

In the treatment of constipation, dietary nutrition is necessarily provided. It should include products that have irritating effects on the intestinal wall( fiber and dietary fiber).Fiber and bran increase the volume of the stool, improve the structure. It is necessary to refuse refined and high-calorie food, because it does not load the intestines at all. Recommendations refer to persons without enterocolitis and other pathology.

The most useful are:

• bread with bran, rye;
• beet and pumpkin;
• greens;
• salad of fresh carrots and apples, vinaigrette;Zucchini and aubergines;
• prune;
• oranges;
• apricots;
• peaches;
• plums.

At any time of the year you can drink a decoction of dried apricots, figs, there is a salad of sea kale. Very useful for patients with constipation are sour-milk drinks with bifidobacteria. Fruits and juices that have astringent action( blueberries, pears, dogwood, pomegranates, bird cherry), alcohol, sweets are excluded.

From the diet, vegetables should be removed with excessive irritation of the intestine, hard-to-digest products that promote increased gas production( cabbage, beans, onions, garlic, radish, mushrooms).All fatty, sharp and fried dishes, pickles are forbidden. It is necessary to drink at least 1.5 liters of water. Better on an empty stomach.

Alcohol should be abandoned completely

How to change the mode?

The necessary physical load can be obtained by walking on foot, including in the morning exercise complex exercises for the abdominal press. You should use transport less and sit at the TV.

Laxatives

Drugs are recommended in the absence of the effect of a diet. Take them necessary at night. The effect comes after 10-12 hours. In the pharmacy network, you can choose and alternate:

• Isafenin,
• Regulax,
• Slabilen,
• Bisacodyl,
• Lizalak,
• Slabikap,
• Guttalax,
• Phytolax. Castor oil is an ancient folk remedy. It should be drunk in the evening, diluted with kefir.