Constipation is a common disease with various manifestations caused by various reasons. It is manifested in that under normal diet conditions, stools are too few, too hard, and too difficult to pass. The symptoms persist for a period of time and make the patient feel uncomfortable. With the improvement of people's living standards, changes in lifestyle, especially changes in dietary structure and increased social pressure, constipation has become a problem that plagues the majority of the population. More and more people are beginning to pay attention to constipation and seek treatment.
The current diagnostic methods for constipation mainly include:
1. Clinical manifestations
1. Ask for medical history: A detailed medical and surgical history can help identify general constipation. A complete understanding of the concept of constipation is also based on medical history, including: decreased bowel frequency, which is generally considered to be less than 2-3 times a week; stool shape changes, less, and hard; bowel symptoms may include bowel movements, rectal fullness, and bowel movements Incompleteness and prolonged defecation time can be quantified by "greater than 25% of the time during defecation process" or "defecation time more than half an hour".
2. Physical examination: A comprehensive physical examination, including a detailed neurological examination, helps confirm constipation caused by systemic diseases. General condition, pay attention to whether there is anemia; routine abdominal physical examination pay attention to whether there is mass and gastrointestinal type.
3. Anus finger examination: has important prompting significance. Through inspection, it can be observed whether there is peeling, infection, hemorrhoids, polyps and rectal prolapse in the perianal area. Examine the pelvic floor muscles to rule out defecation disorders caused by uncoordinated movements. Palpation of the rectal wall helps to find rectal intussusception, decreased sensitivity, etc. Digital rectal examination has a high detection rate for anal spasm and rectal protrusion in patients with defecation disorders.
Two, imaging examination
1. Abdominal plain film: limited value, but patients with suspected intestinal obstruction need to be checked.
2. Barium enema: anatomical abnormalities can be found, such as megacolon, intracavitary mass, extraintestinal compression, etc.
3. X-ray defecography: changes in the shape and function of the rectum and anal canal can be found, such as weakness of the levator anus, intussusception of the intestinal mucosa, and rectal protrusion.
4. Magnetic resonance defecography: used to assess anorectal dysfunction, but it is expensive, which limits its application.
5. Colonoscopy: Abnormalities of the intestinal cavity can be found directly.
Three, colon function test
Including colonic transmission test and colonic pressure measurement. For those patients with constipation who are ineffective in improving their diet and using light diuretics and suspected of emptying disorders, detailed colon function testing is of great significance.
Four, anorectal function test
It can evaluate the pressure of the anorectum, and can check the rectal sensation, anorectal reflex and anal sphincter function in the resting state or forced defecation.
In short, a detailed medical history is the first step in diagnosis. Typical clinical manifestations and detailed physical examinations can provide some important information, while auxiliary examinations can further explore the causes of constipation and distinguish functional or structural abnormalities. If you can choose a reasonable method in the process of treating constipation based on specific conditions, you will get twice the result with half the effort.
1 Xie Jing, Han Ying. Current status and progress of diagnostic methods for constipation. Chinese Medical Guide, 2012 (02).