What is atonic constipation?

Regular emptying of the intestine is necessary for the body. It ensures the removal of toxins and toxins. Energy production for life support is associated with the receipt of essential substances with food. In addition, the quality of food is partly responsible for the purification process.

Atonic constipation is one of the types of impaired excretion of feces. It's not about a one-time delay, but long-term failures of defecation, which are not easy for patients to inconvenience, but real suffering. A healthy person should have a chair every day or every two days, but not after three or more days.

There are many varieties of constipation. They can be caused by:

• getting into the large intestine is not enough "processed" in the previous stages of the remainder of food in diseases of the stomach, duodenum, liver and gallbladder, pancreas;
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• diseases of the intestine with defeat of secretory function, violation of microflora;
• failure of peristalsis (a special kind of contraction of longitudinal and transverse muscle fibers of the intestine), when either muscle spasm or complete relaxation occurs;
• a mechanical obstruction in the course of fecal movement with intestinal obstruction (for example, in tumors).

What factors provide normal peristalsis?

Violation of the contractile activity of the intestine can occur in the pathology of the intestinal wall affecting the nerve endings, against the backdrop of failure of the processes of nervous regulation that ensure proper peristalsis.

For normal peristalsis of the bowels, the responsibility is borne by the vegetative department of the nervous system, which does not obey the will of man. He independently controls the internal organs through the transmission of impulses along sympathetic and parasympathetic nerves.

The anatomy of the muscular wall secures two layers of fibers: externally with a longitudinal direction, from the inside - a circular or annular type.

In the large intestine of the longitudinal fibers form 3 powerful bands

Peristalsis of the intestine is ensured by the successive change of sympathetic and parasympathetic signals, which cause spasm and muscle relaxation through the release of the mediator acetylcholine. Constantly along the intestines there are several waves.

Excessive accumulation of this substance contributes to spasmodic contraction of muscles. The process increases with stress, hard work. On the contrary, with quick disposal or lack of a mediator, the muscles come to a relaxed state.

In a healthy person, both types of signals are balanced and directed to perform the function of cleaning the intestines through the evacuation of stool. It is known that stress and hypodynamia have a significant effect on the disruption of innervation. Such a mechanism plays a decisive role in the pathogenesis of atonic constipation.

Another "irritant" of bowel reduction is food. Peristalsis is strengthened reflexively when exposed to the wall of coarse residues, undigested fiber, but decreases if easily assimilated substances arrive, which are almost completely absorbed into the blood.

With peristalsis, the intestines are supplied with secrets from the upper organs (bile, pancreatic juice). Sufficient motor skills are important for ensuring the quality of food digestion.

Causes and risk factors

Causes of atonic state of the intestine can be any factors that cause a violation of normal peristalsis. These include:

• lack of sufficient motor load (the need for prolonged bed rest, paresis and paralysis, laziness);
• monotonous food with flour products, meat, fatty dishes without sufficient vegetables and fruits - a frequent cause of atony in obesity;
• insufficient water intake or drinking water with a high calcium content, significant fluid loss in the heat, with sweat, vomiting (more typical for the child);
• chronic diseases of the intestines and digestive organs, especially with ulcerous and erosive lesions of the mucous layer;
• the abuse of cleansing enemas and laxatives depletes nerve endings in the intestinal wall, leading to a loss of muscle tone;
• alimentary dystrophy due to starvation is accompanied by a sharp loss of energy, atonic constipation is one of the problems of people in the recovery period after a long absence of food, accompanies attempts at losing weight;
• endocrine diseases caused by a decreased function of the pituitary, ovaries, thyroid (especially in women and men in menopausal age) affect the nervous system and disrupt intestinal motility;
• close to the endocrine problems is the physiological state of pregnancy, atonic constipation can take a long time and does not cease after delivery;
• in elderly people, muscle atrophy is important;
• increased mental and emotional stress;
• toxic effects of certain drugs, the consequence of poisoning with poisonous substances;
• complication after surgery on the intestines, infectious diseases (dysentery).

Long breaks in meals, attempts to starve to lose weight, eating "on the go" lead to the opposite effect

Symptoms of Atonic Constipation

The accumulation of stool in the large intestine stretches the bowel, presses on adjacent organs. Therefore, patients complain of a rare emptying of the intestine, the need to push hard, take a special pose "squatting."

There is a feeling of raspiraniya in the abdomen, dull pain along the bowels, in the right hypochondrium. After emptying, stony hardness of stool masses, soreness in the rectum, admixture of blood on the stool surface caused by hemorrhoidal bleeding are noted, local pains appear in the rectum in connection with cracks.

Low intestinal peristalsis disrupts liver function. In the blood there are uninfluenced toxic substances. Excessive workload with prolonged course of the disease leads to the manifestation of signs of intoxication:

• loss of appetite;
• there are headaches;
• worried about weakness, nausea;
• often the temperature rises to small figures;
• a person becomes irritable, does not sleep well;
• for women is characterized by tearfulness;
• increased hair loss;
• the skin condition worsens (dryness, itching, wrinkles on the face, pale or icteric hue, acne);
• possible mental disorders (weakening memory, suspiciousness, explosions of aggression), the mood depends entirely on how the patient went to the toilet.

How does the atony of the intestine manifest in the child?

The problem of atony of the intestine can arise in the baby of infants. It is believed that up to three months, the main reason is the imperfection of the digestive system. Normal defecation should occur 1-2 times a day, in newborns up to 8 times.

Age-related anatomical features of children are weak development of the muscular layers of the intestine, the sigmoid part of the colon has a strong crimp, reduced secretion of the digestive organs.

There is a complete dependence on the quality of nutrition (milk of the mother), the response to the introduced complementary feeding, as well as the importance of adherence to the regime, surrounding conditions and conditions, fright, irritation of parents, and other psychic influences.

When the defecation is delayed, the child becomes irritable, often cries, fits, refuses to eat

The cause of constipation in a child can be a helminthic infection. In this case, there are rashes on the skin, the baby scratches the anus zone (if the helminth are the pinworms), you can hear a rumbling in the swollen abdomen. The attention of parents and the supervision of the district pediatrician will help to solve the problem.

Diagnostics

To correctly diagnose, the doctor should learn to listen to the patient's complaints and receive the necessary information from them. It should be borne in mind that people with constipation always consider feces and are able to describe their condition for a long time.

With atonic constipation, when it is possible to achieve emptying, the denser part of the feces first (patients speak of "stones"), and then a soft consistency. It is necessary to find out the type of human nutrition, the features of professional activity. It is important to know how the patient eats at work.

In the situation with constipation, it is always necessary to exclude the mechanical factor - polyps, intestinal tumors, adhesive obstruction. In men, the symptomatology can cause a tumor of the bladder or prostate. In women, adhesions form chronic inflammatory diseases of the uterus and appendages, the operations of a caesarean section.

The method of X-ray diagnostics with the use of barium suspension and subsequent examination of its movement along the intestine, as well as irrigoscopy (introduction of contrast with the enema) continues to be used in polyclinics

The patient is recommended to take tests:

• blood, general clinical and biochemical for testing the functional state of the liver and pancreas, on cancer markers;
• urine;
• feces on scatology, eggs of worms (the doctor will appoint a child);
• women are referred to a gynecologist, men need a finger examination of the prostate;
• Fibrogastroscopy - will check the stomach and reveal a violation of secretion;
• colonoscopy - the introduction of an optical probe into the rectum to examine almost the whole of the large intestine - is necessary in order to reject the suspicion of tumor growth, to reveal intestinal diseases that cause constipation.

Treatment of atonic constipation with exercise and diet

Before treating constipation with medications, the doctor will advise you to pay attention to the lifestyle (sufficiency of movements) and adjust the nutrition. Patients with atony should start every morning with gymnastics for the abdominal and intestines.

It will be useful to alternately pull the knees to the chest in the prone position, "scissors" at an angle to the floor at 45 degrees and below, twisting with a rise of the trunk upward, and also throwing the legs behind the head.

Self-massage of the abdomen - is performed clockwise by pressing movements followed by a gentle deep immersion of the fingers and a sharp removal

Walking is a natural reflex stimulator of the intestine. The process connects all the necessary muscles. Therefore, patients are recommended to spend more time on walks, part of the way to work must pass on foot.

Basic power requirements:

• frequency of meals should be 5-6 times a day;
• Over long periods, overeating is unacceptable;
• The sandwich method of food is excluded, at work it is necessary to adapt to the warming up of the food brought with them or to the dining room.

It is necessary to limit:

• culinary products, cakes, sweets;
• fried and smoked meat products;
• coffee to 1 cup a day;
• beer and alcohol are better excluded;
• carbonated water;
• hot sauces, lard, mayonnaise.

Preferences should be given to:

• cottage cheese;
• kefir and fermented baked milk;
• buckwheat porridges;
• boiled lean meat and fish;
• vegetable salads, casseroles;
• seafood;
• fresh fruit;
• rye and "Doctor" bread with bran.

Medication

If diet and exercise do not bring relief, then the doctor prescribes special preparations to stimulate the intestines. They are included in a large group of anticholinesterase drugs, all contribute to the accumulation of acetylcholine and thus restore motor function.

Itomed - used for vomiting, nausea, heartburn. It is not recommended for pregnant and lactating women, children under 16 years, if there is a suspicion of a mechanical obstruction or bleeding in the intestine, as well as with a deficiency of lactase.

Negative symptoms include:

• allergic reactions;
• salivation;
• Suppression of leukocyte and platelet synthesis;
• tremor of hands;
• gynecomastia in men;
• headache;
• jaundice.

Limited use in cases of impaired renal and hepatic function

Other drugs of the group do not differ in the negative consequences from Itomed:

• Ganaton,
• Motilium,
• Coordination,
• Montana,
• Proserin.

They are supplemented by Peristil, which can cause cardiac arrhythmias, requires caution in patients in old age. Kalimin 60 N - is contraindicated in urolithiasis, bronchial asthma. The negative is the narrowing of the pupils, nausea, bradycardia, vomiting and increased secretion in the bronchi.

As we see, such pathogenetic therapy is too dangerous for outpatient treatment, especially for elderly patients with various chronic diseases.

Therefore, gastroenterologists recommend to use laxative drugs for bowel evacuation. Produced in tablets, drops, food supplements, rectal suppositories. It is better to use them at night.

Negative property - the adaptation of the body to a single medicine. Lack of effectiveness with prolonged use. Some products can cause too much irritation of the intestinal mucosa, contribute to further inflammation, violate the bacterial flora.

The patient is recommended to alternate laxatives of different kinds:

• Phenolphthalein,
• Izaman,
• Isafenin,
• Regulax,
• Lizalak,
• Bisadil,
• Slabilen,
• Slabikap,
• Phytolax,
• Guttalax.

Castor oil is better taken in a mixture with kefir

Long-term use of laxatives leads to a state of "lazy bowel". Rectal glycerin suppositories are administered once. After 20 minutes due to irritation of the rectum, there is a urge to go to the toilet. Candles can not be used for exacerbation of hemorrhoids and inflammation of the rectum.

To reduce dependence on laxatives, physiotherapy is prescribed to stimulate the intestines. Circular and Charcot douche are recommended, electrophoresis on the intestine area with a solution of calcium chloride and Proserin, diadynamic currents on the abdominal muscles.

Treatment with enemas

The enemas with intestinal atony are distinguished by their goals:

• Cleansing- is carried out by the amount of liquid 1-2 l, it can add decoctions from plants with anti-inflammatory effect (chamomile, calendula), apple cider vinegar. Emptying the large intestine occurs immediately.
• Oily- The therapeutic effect is to soften the feces, improve the movement of the intestine, the volume is 150-200 ml, it is necessary that the temperature of the solution is close to 38-39 degrees. Before the oil enema, purification is carried out. It is best to do the procedure before bedtime. Defecation should be expected after 8-10 hours.
• Hypertensive- a half-glass of warm water has a tablespoon of salt, the solution is well mixed, the action is based on irritation of the mucosa and nerve receptors of the intestine. The volume of enema is not more than 100 ml.

The most convenient equipment for oil and hypertonic enemas

Contraindications of the method include any signs with suspicion of "acute abdomen", appendicitis, intestinal obstruction, intestinal bleeding and the presence of a rectum crack, paraproctitis, acute hemorrhoids.

Experience of folk medicine

Folk remedies patients are forced to use courses and alternate because of the possibility of addiction. Relaxing effect on the intestines have:

• decoction of flax seeds;
• morning reception of a glass of water with a spoon of honey;
• compote of apples, cherries, apricots;
• pickled cabbage brine with yeast;
• plum, carrot, beet juice;
• broth of oats, dill seeds.
• aloe with honey.

Preventive measures

Warn atony intestines can be, adhering to certain rules in life. We need to walk more, lie less on the couch and spend time at the TV, stick to a healthy diet in the diet, drink water at 1.5 liters per day, do not chase after fashionable diets.

In daily workouts do not forget to include exercises for the intestines, give up alcohol, smoking. Try to develop a habit (conditioned reflex) to defecate at the same time.

Learn to accept any situation and deal with problems as they arise, rather than torment yourself with fears in advance. Prevention and treatment of atonic constipation helps to avoid intoxication of the body, to eliminate health problems by natural methods of bowel cleansing.