One, constipation is divided into
1. Primary constipation: The cause of the disease is unclear, and there are no other diseases that cause constipation, so it is also called idiopathic constipation.
2. Secondary constipation: secondary to other diseases, it is a symptom of other diseases, the primary disease is controlled, and the constipation is eliminated. This type of constipation has the highest incidence, and failure to pay attention to the examination will often lead to misdiagnosis. For example, secondary constipation caused by colorectal cancer may delay surgery.
2. Primary constipation, also known as functional constipation, can be divided into
1. Slow transit constipation: The characteristic is that there is no urge to defecate, only swelling.
2. Outlet obstructive constipation: It is characterized by intention to defecate but difficult to discharge. This type of disease is more common, such as rectal protrusion, intramucosal prolapse, pelvic floor hernia, puborectal muscle spasm or hypertrophy.
3. Mixed constipation: the first two types coexist.
3. Inspections are required (our department has complete inspection methods):
2. Barium enema
3. Defecation imaging
4. Pelvic quadruple (female) or triple radiography (male)
5. Anorectal pressure measurement
6. Anorectal EMG
7. Colonic transmission test
1. Medication: It is the main treatment method. There are a variety of laxatives and should be replaced frequently. It is best not to use one medicine continuously because it can cause melanosis of the colon.
2. Surgical treatment: only suitable for a small number of patients with intractable constipation. Therefore, this type of surgery is only a symptomatic treatment, not a cause treatment. The indications are very strict. The surgery itself may also have complications. For example, pelvic surgery can cause sexual dysfunction in men. Women can cause infertility.
A. Slow transit constipation: subtotal or total resection of the colon.
B. Double colonic stoma: elderly patients with intractable constipation and unable to tolerate resection.
C. STARR operation: patients with rectal protrusion and rectal mucosal prolapse.
D. PPH surgery: patients with milder rectal protrusion, rectal mucosal prolapse, and hemorrhoids.
E. Obturator internal muscle autotransplantation: severe pelvic floor decline.