Constipation, treatment of constipation
Constipation (constipation) refers to the decrease in the frequency of bowel movements, the number of bowel movements in a week is less than 2-3 times, or the bowel movement is only once in 2-3 days. When the stool volume is small and dry, it is called constipation. Symptoms and signs of constipation: Most patients with chronic constipation only present with difficulty in defecation, dry stools, defecation only once in a few days or even a week, and left abdominal cramping pain and falling sensation during defecation. Accompanied by severe abdominal pain, vomiting or blood in the stool, constipation caused by acute intestinal obstruction should be considered. Enough attention must be paid to patients with constipation to find the cause of constipation. Principles of treatment of constipation: 1. Acute constipation is mostly caused by intestinal obstruction, so the treatment is mainly for the cause. 2. Constipation is caused by diseases near the anus and rectum, such as acute constipation caused by anal fissure, anal fistula, peri-anal abscess, huge internal hemorrhoids complicated with infection, etc. These diseases should be actively treated, and at the same time, soften the stool or take medicine from the anus. The method to facilitate the discharge of stool. 3. If acute constipation is caused by taking certain drugs with constipation side effects, the dose should be reduced or stopped. If necessary, add a laxative that is less irritating to the intestinal tract. 4. For some chronic constipation caused by organic diseases, when the cause is clear, the cause should be treated. 5. In case of constipation for a long time, even more than 1 year, or repeated and intermittent constipation, it can be considered as intestinal dysfunction constipation. Encourage patients to eat more cellulose-rich vegetables, bananas, pears, watermelons and other fruits to increase stool volume and drink more water. Honey can be taken orally frequently to play a laxative effect. In the treatment of constipation, volumetric laxatives can be used to increase the volume of stool to enhance the stimulation of stool to intestinal receptors. Lactulose is commonly used. Abbott lactulose oral solution (trade name: Dumic, Lactulose Oral Solution, chemical name: 4-O-β-D-galactopyranosyl-D-fructose), each 100ml Dumic contains 67g lactulose ; Galactose≤10g, lactose≤6g. Constipation or clinical need to maintain soft stools, commonly used lactulose oral solution: 5 ml per day for infants; 5-10 ml per day for children 1-6 years old; 10-15 ml per day for children 7-14 years old; 15 ml per day for adults -30 ml. After a few days of treatment, the dose can be reduced according to the patient's condition. This product should be taken once at breakfast. According to the mechanism of lactulose, clinical effects can be achieved within one to two days. If there is no obvious effect after two days, consider increasing the amount.
Hepatic encephalopathy: the initial dose of treatment of pre-cerebral coma and hepatic coma: 30-50ml, 3 times a day. Maintenance dose: According to individual circumstances, it should be adjusted to a maximum of 2-3 times a day for soft stools and stool pH value of 5.0-5.5.