A young patient who came to Shanghai for the first time, the environment changed and he was busy with work, and did not have a bowel movement for a week. Later, a friend took laxatives under the guidance of a friend. He started to have bowel movements 3 days after the medicine. Controlled, had to put on a sanitary napkin, abdominal distension, painful anus bulge. Specialist examination revealed that his perianal feces were contaminated, his skin was pickled and damaged by fecal water, and his anus protruded outward. The digital examination enters the rectum, the anorectum is filled with stone-like hard stools, and the lower part of the rectum expands. The condition relieved after enema defecation treatment in the outpatient department.
This symptom is fecal impaction, acute constipation, or a large amount of soft or hard feces accumulating to block the anal opening, and the exit is paralyzed. It is like a disordered state where a turbulent flow of people squeezes out the theater door, which will break through the door and even a stampede.
Fecal impaction is more common in elderly people who are bedridden and less active, or people with irregular daily life.
Fecal impaction is also prone to occur after anorectal diseases such as hemorrhoids. Fecal impaction caused by difficulty in defecation after hemorrhoid surgery is a huge "black hand" that increases postoperative discomfort, causing edema, hematoma, and bleeding in anal wounds.
After hemorrhoid surgery, the patient fears wounds and defecation, or reduces dietary activities, and becomes dry after several days of inconvenience; or consumes too much laxative food and laxatives, constantly squatting in the toilet, anal congestion, anal muscle spasm, anal swelling and bowel movements. If it doesn't go away, it will be laborious and time-consuming to discharge the pulpy stool, which will eventually cause fecal impaction.
Defecation is an important step for recovery from hemorrhoid surgery.
After hemorrhoid surgery, "one will destroy everything", unsmooth defecation, the patient's pain increases, and the doctor's work will be affected and completed perfectly.
Why is it easier to have bowel movements after hemorrhoids?
Poop is related to the anal outlet, and more related to the intestinal motility, and the important factor that affects the intestine is psychology. The brain-gut axis and intestinal microecological theories confirm that the intestine is an emotional organ, which is easily controlled by emotion, environment, and diet.
After hemorrhoids, postoperative wounds exist, and the recovery period is long, which will make the patient pay too much attention to defecation, and special wounds will also aggravate the patient's feelings of shyness, tension, fear and anxiety.
Many patients with a history of constipation are very easy to worry about poor bowel movement, and worry that they will contaminate the wound with their bowel movement. They are also afraid of the pain of the wound and will control the bowel movement, or the pain will end the bowel movement early. The stool will be stored in the intestinal cavity for too long, and the water will be absorbed and dried. Harden. Make bowel movements more difficult.
In addition, due to wound inflammation, edema stimulation, and anal sphincter spasm, it may cause frequent bowel movements, and the desire to squat on the toilet cannot be controlled. Long squatting and prolonged sitting make it difficult to defecate a vicious circle.
High psychological pressure will definitely affect intestinal function. Lead to intestinal flora imbalance, gastrointestinal motility disorder, brain-gut axis dysfunction. Defecation disorders affect the wound and the discomfort of the wound, which in turn will stimulate the growth of bad mental emotions, forming a vicious circle, and the pain during the recovery period after hemorrhoid surgery is aggravated.
Therefore, the postoperative response to stool disorders is first of all psychological.
Medical care attaches importance to psychological factors, communicates with patients about medical conditions, conditions and treatment plans, informs the treatment cycle and possible risks, explains the operation situation, and comprehensively tracks and manages the postoperative recovery period. Convey appropriate assurances and hopes, and describe other examples of good endings.
The patient fully understands the medical condition and their own characteristics, and knows that the operation has risks and pains, but more clearly, the risk is controllable, the risk is a small probability event, and the pain can be alleviated in many ways. Patients should understand the impact of bad emotions on constipation, understand the pros and cons of deliberately inhibiting and controlling bowel movements, and rebuild defecation habits after surgery.
Patients can focus on their main problems, find their main psychological roots, and use multiple strategies to cope with stressful situations. Improve medical compliance, healthy living, perform various mood-relieving behaviors such as music and walking, do things that are pleasant to the mood, and coordinate and manage psychological and physical stress.
Followed by diet, lifestyle, exercise, and auxiliary drugs.
For anorectal diseases such as hemorrhoids, day surgery is advocated, leaving hospital quickly after surgery, reducing psychological and physical interference in the hospital, returning to normal life as soon as possible, and rebuilding bowel habits as soon as possible.
1. Diet structure adjustment
After the operation, there is a positive correlation between a reasonable diet and wound recovery, which is not what many patients think-controlling diet, not defecation or less defecation is conducive to wound recovery.
The quality and quantity of the diet affect the formation and excretion of stool. "Quality" refers to the reasonable combination of high-quality protein, crude fiber and dietary fiber; "quantity" refers to the normal dietary amount. Food cellulose is good for stimulating bowel movements. Sufficient capacity and weight are also an effective way to stimulate bowel movements to produce defecation reflex and promote bowel movements.
2. Regular life, reasonable arrangement of work, appropriate sports and entertainment
Regular work and rest time, regular eating time, and regular exercise in the gastrointestinal tract are conducive to the formation of good bowel movements.
Arrange a certain amount of work and entertainment, you can divert attention through work and entertainment activities, do not entangle defecation and wounds, have a certain amount of daily exercise, increase body resistance, and help gastrointestinal health.
Cultivate good defecation habits, focus on defecation during defecation, read the newspaper, smoke or think about things that are not related to defecation during defecation, resulting in prolonged squatting in the toilet, and prolonged squatting after surgery is prone to anal edema, edema and inflammation. It is easy to cause anal spasm, discomfort from falling bulge, frequent bowel movements, and aggravate bowel difficulties.
3. Maintain normal intestinal flora, intake dietary fiber, eat yogurt, or supplement microecological preparations, such as probiotics, prebiotics and synbiotics.
4. Proper use of the drug. If you have frequent bowel movements, anal swelling, lack of defecation, or incomplete defecation, you can use Kaisailu under the guidance of a doctor. Patients after anal surgery should be given a mild laxative on the next day of surgery. There are also necessary analgesics or anal plugs.
5. Avoid the abuse of drugs, especially antibiotics, which can cause flora imbalance, and stimulant laxatives, which can damage the nerves of the intestinal wall and increase intestinal inertia.
Postoperative defecation disorders not only affect the postoperative wound, but also severely test the patient's psychological state. If you can have a normal bowel movement after the operation, the discomfort after the operation is relieved by 90%. After hemorrhoid surgery, relax the mood, rebuild bowel habits, defecate regularly, and defecate smoothly, which can greatly reduce the pain, shorten the wound healing time, and the wound will recover smoothly, which will make the hemorrhoid surgery perfect.