1. What is constipation?
Constipation is a symptom that people most often occur. It is estimated that half of the people (50%) have had a full name, especially the elderly, pregnant women and children with a high incidence, and many people feel painful for this.
Normal people’s food enters the gastrointestinal tract, after digestion and absorption, it takes about 24-28 hours to turn the residue into feces and excrete from the body. The basic defecation interval exceeds 48 hours (two days), which can generally be regarded as constipation. But everyone’s bowel habits are different, the food they eat is different, and the bowel time will be different. Some people are accustomed to defecation once every 2-3 days, and some people eat less after surgery, even 5-6 days later. As long as the stool is not dry and hard, and the bowel movement is smooth and painless, it cannot be counted as constipation, which is a normal physiological difference. Stool becomes dry and hard, and it is prolonged during defecation, it is difficult to pass, the anus is swollen, painful, or it has caused symptoms such as abdominal distension, abdominal pain, abdominal pain, excessive farts, loss of appetite, dizziness and fatigue. . People with these symptoms should be considered as constipation even if they defecate several times a day.
2. What are the causes of constipation?
The causes of constipation can be divided into two categories: functional and organic.
The so-called functional cause means that the normal physiological function of defecation is out of balance or disorder due to some reasons, and the stool cannot be discharged from the body on time. Common reasons are:
(1) Mental and neurological factors. Because defecation is an action controlled at will by the cerebral cortex, people can arbitrarily prolong the defecation time. When work is busy or there are no suitable defecation places and conditions, they can use the cerebral cortex and the autonomic nervous system to freely and not The random reflex activity can relieve the bowel intention, and the stool returns to the sigmoid colon through the upward retrograde peristalsis of the rectum, without defecation temporarily. This ability to freely control defecation activities allows people to adapt to environmental changes and develop the habit of regular defecation. However, if the defecation time is often arbitrarily prolonged, the nerve cells on the rectal wall will become less sensitive to the pressure generated by the stool entering the rectum over time, so that the residence time of the stool in the rectum will increase without causing defecation reflexes and unconsciousness. . Some anal diseases such as anal fissures, perianal abscesses, hemorrhoids, etc., patients are afraid of pain, prolapse, and bleeding during the stool, and often consciously control and prolong the defecation time, which can also cause this habitual constipation. Patients with depressive psychosis and hysteria, who are often constipated, also fall into this category. Many patients with brain injuries and ruptures often suffer from constipation, which also falls into this category. Many encephalopathy, such as stroke, tuberculous meningitis, epidemic meningitis, and spinal cord injury, rupture, often first have a temporary incontinence of feces, and then turn into a very important position in the formation of constipation, which is caused by rectal constipation. main reason.
(2) Slow movement of the entire gastrointestinal tract. Nutrient deficiency, especially B vitamin deficiency, chronic opioid poisoning, hypothyroidism, etc., can affect the normal peristalsis of the entire gastrointestinal tract, prolong the passage of food, and cause constipation due to slow movement.
(3) Insufficient stimulation of the intestinal tract If you eat too little, the cellulose and water in the food are insufficient, which can not form a certain amount of irritation to the intestine, causing the colon to move, and promptly push the food residue to the rectum. After entering the rectum, because of the small amount, it can not produce enough pressure to stimulate the nerve sensor cells in the rectal wall and produce defecation reflex, thus causing constipation.
(4) Lack of defecation motivation. Defecation requires not only the relaxation of the anal sphincter and the upward and outward pulling of the levator ani muscle, but also the decline of the diaphragm, contraction of the abdominal muscles and contraction of the thigh muscles to enhance discharge. When people forcefully defecate, they often hold their breath temporarily (stop breathing). Through the contraction of the above muscles, the intrathoracic pressure rises sharply to promote the excretion of feces. The abdominal wall is loosened due to illness, old age and infirmity, or women's childbirth. After anal surgery causes muscle damage, the contractility of the diaphragm, abdominal muscles, and levator ani muscles is weakened, resulting in lack of defecation motivation and constipation.
(5) The reactivity of the intestinal wall is weakened. Many people will feel this way. After thinning and diarrhea, they will often experience constipation for a period of time. This is the result of weakened intestinal wall reactivity. After the nerve cells in the intestinal wall are diarrhea caused by inflammation and dysentery, they often have short-term defecation weakening. Although they are stimulated enough, they cannot cause defecation reflexes in a timely manner, and instead make constipation more serious.
(6) Lead, arsenic, mercury, phosphorus and other poisonings; taking calcium carbonate, aluminum hydroxide, atropine, probensine, opiates and other drug-induced constipation.
The so-called organic constipation refers to the occurrence of substantial lesions in the abdominal cavity, large intestine and anus, which obstruct or affect the normal passage and discharge of stool. The resulting constipation. Such as benign and malignant tumors of the colon and anus. Intestinal narrowing caused by chronic inflammation, rectal spasm and stenosis caused by Hirschsprung's disease, intestinal adhesions after surgery, partial intestinal obstruction, etc., or huge tumors in the abdominal cavity, such as ovarian cysts, uterine fibroids, and pregnancy , Ascites, etc. compress the large intestine, making it difficult to pass stool, and constipation can occur. Because this type of constipation is caused by organic diseases, it is necessary to remove the cause through surgery to cure the constipation.
3. What effect does constipation have on the body?
Short-term constipation generally has little effect on the body, while long-term constipation has many adverse effects on the body.
In constipation patients, excessive stagnation of feces in the intestinal cavity can cause discomfort, discomfort, distending and discomfort in the left lower abdomen, tenesmus, and inability to pass stool. Long-term constipation can cause upper abdominal discomfort, loss of appetite, gas, nausea, nausea, abdominal pain, bowel, and excessive farts. In spastic colonic constipation, it can also cause paroxysmal abdominal pain, soreness and pain in the waist, sacrum, and back of the thigh, and the excretion of feces is shaped like sheep feces and is black and hard.
Habitual constipation, especially patients who often take laxatives or enema, will also have symptoms of autologous poisoning. It is generally believed that food residues stay in the intestines for too long and are prone to fermentation and corruption, and produce a large amount of gas, such as nitrogen, carbon dioxide, methane, indole, hydrogen sulfide, etc. These gases accumulate in the intestinal cavity in large quantities, which can cause the intestinal tube to expand, which is called the tympanum. The tympanic intestine can mechanically block venous return and impair breathing and digestion. Abnormal fermentation and spoilage of intestinal contents can also produce a large number of toxic substances, such as acid, acetic acid, ethanol, phenol, ammonia, hydrogen sulfide, indole, histamine, etc. This substance cannot be excreted in time by people with constipation, and the result is absorbed into the blood. A series of autologous symptoms such as dizziness, fatigue, apathy, loss of appetite, nausea, bitter mouth, bad breath, breath, upset, irritability, etc. appear in the patient. Sometimes it can cause anemia and malnutrition. Some people think that this long-term self-poisoning can also promote premature aging or premature aging, affecting health and longevity.
Constipation can also cause anorectal diseases such as hemorrhoids, anal fissures, anal infections, and rectal prolapse. Exacerbate the symptoms of diseases such as high blood pressure, myocardial infarction, and emphysema, so some people call "constipation the enemy of health." Therefore, constipation should be treated actively and not let it harm your health.
4. Why are the elderly prone to habitual constipation?
The elderly suffer from habitual constipation, and constipation has become one of the most common senile diseases. Why are the elderly prone to habitual constipation? The common reasons are as follows:
(1) As the tension and contraction of the diaphragm, abdominal muscles, and levator ani muscle weaken after ageing, defecation motivation will also decrease, making it difficult to discharge stool. Therefore, from the perspective of physiological changes, constipation is a manifestation of aging and reduced metabolism in a certain sense. After old age, constipation will follow.
(2) As the amount of activity decreases after old age, the amount of food consumed will also decrease, and the amount of natural excretion will also decrease. In addition, the old teeth fall, and most of them cannot chew cellulose-rich vegetables and fruits. Therefore, a partial diet of fiber-free foods will inevitably reduce the irritation of the food to the intestinal tract and cause constipation due to the lack of cellulose.
(3) After old age, due to lazy activities, often neglect to defecate regularly, or it is customary to have a bowel movement every few days. Intentionally extending the interval between bowel movements is also an important reason.
(4) Many elderly people suffer from dry stools and difficulty in passing out. They take laxatives for a long time. Once they are stopped, they will increase constipation. This makes it more dependent on laxatives, and as a result, the irritability of the intestinal wall becomes lower and lower. Without laxatives or enema, the feces staying in the rectum can even form incarceration or fecal stones, compressing the anus and producing tenesmus, which stimulates the rectum to increase secretion, and mucus flows out from the anus from time to time to form the so-called "pseudo diarrhea." At this time, the enema can't decompose and discharge the feces, and it is often necessary to dig out the feces from the anus piece by piece with fingers or hemostatic forceps.
In addition, the prevalence of anal diseases such as hemorrhoids and prolapse of the anus, as well as colon and rectal tumors, is also high in the elderly, and these organic diseases can also easily cause constipation.
Although based on the above reasons, the elderly are prone to constipation, but constipation is by no means inevitable after old age. As long as you pay attention to your diet and adjust your intake appropriately, you can avoid constipation.
5. Why is it said that the treatment of habitual constipation mainly depends on self-adjustment?
The general principle of constipation treatment is: find the cause and treat it according to the cause; adjust diet and bowel habits reasonably; correct the wrong practice of relying on laxatives to defecate.
The majority of patients with functional constipation are caused by mental disorders, lack of food or partial eclipse, lack of fiber or vitamins in food, neglect of timely defecation, lazy activity or exercise, long-term dependence on laxatives to defecate and other bad lifestyle habits , So it is also called habitual constipation or simple constipation. As the reason lies in unsanitary living habits, treatment should mainly rely on self-adjustment and correct bad habits in accordance with scientific and hygienic methods. The specific methods are as follows:
(1) To develop the habit of bowing down regularly. Colon movement has a certain regularity. After getting up in the morning, as the person changes from lying down at night to standing up, an upright reflex will occur, producing a large group of peristalsis, and pushing the stool down into the rectum. , Cause defecation reflex, so the daily bowel movement is most physiological in the morning. If the constipated person can intentionally go to the toilet every morning for about 5 minutes, after a certain period of time, normal bowel habits will be established. But this is not the same, as long as you can defecate once a day, the time is noon or night.
(2) Pay attention to breakfast. After breakfast, food entering the stomach can cause gastro-colon reflex, causing the colon to produce strong peristalsis, sending feces outside, which is conducive to discharge. If a person with constipation pays attention to breakfast and makes good use of the situation, it will be easier to pass the bowel movement in the morning after breakfast.
(3) Go to bed and get up early. Getting up early, moving for a while, having breakfast in time, defecation calmly, and making full use of the rational defecation moment in life is the best way to correct habitual constipation. Wake up late and have to catch up with work, often fail to eat breakfast, relieve stool, disrupt normal physiology, most likely to cause constipation.
(4) To omnivorous grains and vegetables, eat more cellulose and vitamins. For refined white rice, white noodles, refined meat, eggs, vegetables, and fruits (such as various canned foods), fiber and vitamins are either low in content or destroyed. This staple food looks high-quality and tastes delicious, but it is not necessarily completely scientific and reasonable, and is good for health. In Europe and the United States and other countries that rely mainly on refined diets, there are many people with constipation, and the incidence of colorectal cancer is high. It can be seen that this refined diet is not advanced and perfect. Various vitamins and cellulose are mainly contained in the skins of green vegetables, grains and melons. Therefore, the more assorted staple foods, the better. The thicker the food, the greater the stimulation of the intestinal cavity, which is conducive to defecation. Easily chewed cellulose is a good laxative medicine.
(5) Milk and cold boiled water are good laxative medicines. Milk is rich in lactose and fatty acids, which are not easily digested and absorbed. It can moisturize the intestines, especially cold milk, which has a good laxative effect and can supplement nutrition. Kill two birds with one stone; cold water and cold drinks can stimulate the intestines and increase peristalsis. Some people think that drinking a glass of cold water after getting up in the morning is better than taking medicine. In addition, honey, black sesame seeds, and vegetable oil also have a good laxative effect and can be taken appropriately.
(6) Activities, activities, walking, running, taking deep breathing exercises, turning around to move the waist, practicing Qigong, Tai Chi, participating in various cultural and sports activities and physical labor, can strengthen gastrointestinal activities, increase appetite, plant The nerves are adjusted, the abdominal muscles, diaphragm, and thigh muscles are exercised, and bowel movements are smooth. Rural elderly people who work often have less constipation, while urban elderly people who are lazy and pampered have the most constipation. This vividly illustrates this problem.
(7) When you have a bowel movement, do not ignore the meaning of bowel movement. Whether working, studying, traveling by car or boat, flying, or watching a movie, take time to go to the toilet if you want to. Don't let the stool return to the sigmoid colon and cause constipation for a long time. Prompt defecation is not an uncivilized or indecent thing, on the contrary it is a hygienic habit.
(8) Do not abuse laxatives to make constipation worse.
6. How to treat intractable constipation?
Although the vast majority of habitual constipation can be improved and cured through self-regulation, improvement of life, including habits, etc., there are still a few intractable constipation that require proper treatment according to the cause.
(1) Rectal constipation that occurs due to autonomic nervous system disorders, colonic dysfunction, and decreased rectal sensitivity to stool stimulation. Acupuncture or Aizhi Tianshu, Dachangshu, Zhigou, Daheng, Zusanli and Yanglingquan points can be used. Oral Jichuan Jian: 15 grams of Angelica, 15 grams of Huai Niu Xi, 15 grams of Cistanche, 6 grams of Cohosh, 10 grams of Alisma, 10 grams of Citrus aurantium. Decoction in water, 1 dose a day, take all the two decoctions together before going to bed. There is no diarrhea medicine in this prescription, but the emphasis is on nourishing blood, regulating qi and regulating the intestines. It has a good effect on elderly constipation, pregnant women, post-illness, and post-operative constipation. It is a good prescription for treating intractable constipation.
(2) Due to depression, irritability, or partial eclipse, eating less vegetables, resulting in gastrointestinal dryness, or hemorrhoids, anal fissures, you can take Maziren pills for laxative bowel movement.
(3) Reasonable selection of laxatives and enemas
There are three types of commonly used laxatives:
The first type of diluting laxatives, magnesium sulfate (sulfuric acid), sodium sulfate (glauber's salt), etc., are oral and difficult to absorb salt laxatives, which can form a high osmotic pressure in the intestines and increase the amount of water and chyme. Mechanical stimulation dilates the intestines, enhances bowel movements and defecates. The diarrhea effect is strong and fast, and watery stools are discharged 4-6 hours after taking, often accompanied by abdominal pain. Mainly used for acute constipation and intractable constipation. Not to be used frequently, drink more water at a time.
The second type of irritating laxative is castor oil, rhubarb, senna, aloe vera, phenolphthalein (fruit guide tablets), diacetin (one relax), triacetin (tongshu tablets), etc., mainly by stimulating intestinal peristalsis , To push the intestinal contents downward, and discharge semi-liquid stool after 6-8 hours. After diarrhea, it can cause intestinal irritability-reducing constipation. Therefore, it should not be used frequently. It can only be used several times when the stool is difficult to discharge. This type of laxative is the most commonly self-administered laxative for constipation patients. It is very popular because it can be taken for a while. In fact, it is more diarrhea and more secretive, and more serious.
The third type of lubricating laxative, liquid paraffin, glycerin, etc., is mineral oil that is not absorbed after oral or enema and can hinder the absorption of water at the same time. It has a simple and smooth effect on the intestinal wall and stool. After taking it, it will be discharged after normal defecation time. . This type of laxative is most suitable for elderly people with intractable constipation, particularly dry stools, or weakened defecation ability. Liquid paraffin is taken 10-20ml every night before going to bed, and the next morning to get up and defecate, it is good for regular development. Conditional reflex for defecation, without irritation, can be used as an ideal laxative for intractable constipation.
In the enema, Kaisailu (containing 50% glycerin) is ideal, which is less irritating. Soap and normal saline are more irritating. They can be used for enema if there is severe fecal incarceration. It should not be used frequently to avoid reducing rectal irritability and secondary constipation after irrigation. In short, the treatment should be mainly based on the adjustment of the intake, supplemented by the drug therapy, and resolutely correct the view of relying solely on drugs, so that it can be completely cured.
All kinds of laxatives or intestinal laxatives, it is best to take once every night before going to bed, and relieve the stool after getting up in the morning. This is more in line with the normal physiological defecation time and is beneficial to correct intractable constipation. If you take the medicine 2-3 times a day, and diarrhea once every 4-6 hours, this is obviously not conducive to the formation of regular defecation habits, and the treatment effect will not be ideal. In the past, some doctors and patients didn't know enough about this. Wang Rizhi took the laxative in two or three times. This kind of scattered medication was not taken once at night. Taking it once at night, according to the situation, strengthens the peristalsis of the colon and rectum, and discharges the stool more naturally, which is obviously beneficial to correct the imbalanced bowel function. At the same time, the dosage can be reduced to achieve good results.