1 What is constipation
Constipation is short for constipation. Ordinary people generally think that as long as the stool is dry and the bowel movement is laborious, it is constipation. The medical concept is: feces stay in the intestines for too long, and the defecation time is prolonged. Constipation is caused by defecation less than three times a week.
In fact, constipation is only a common clinical symptom, and many diseases can cause constipation. Constipation may have accompanying symptoms, such as abdominal distension, abdominal pain, and feeling of incompleteness, or there may be no accompanying symptoms.
There is also a clinical situation between normal stool and constipation, that is, the stool is dry (dry). Strictly speaking, dry stool does not belong to constipation, but it can develop into constipation, and medication should be used according to the treatment of constipation.
What is the defecation process of the human body?
After the food we eat is continuously digested and absorbed by the stomach, its residue becomes feces, which is stored in the colon (large intestine), and the feces are excreted from the body through normal colon movement and defecation reflex. Therefore, defecation physiology mainly includes two aspects of colon movement and defecation reflex. Colon movement under the control of nerves has three forms: segmental movement, extension movement and group movement. The segmental movement is formed by the contraction of the limited circular muscles of the colon pouch, which is only conducive to the absorption of electrolytes and does not advance the stool; the intermittent extension movement can slowly push the stool forward, about 1-2 cm per minute; Group exercise can quickly push the stool to the rectum and cause defecation reflex. Under normal circumstances, there is no stool in the rectum. When the group exercises the stool to be sent into the rectum, it excites the baroreceptors in the rectum and generates nerve impulses, causing stool and defecation reflex. With the participation of nerves, the anal sphincter relaxes, allowing stool to be discharged, and then The levator ani muscles contract, empty the rectum, and complete the bowel movement. The defecation process is very complicated and also very important.
2 Under what circumstances does the colon show group movement
Group movement is also called group peristalsis. It is a movement of the colon that travels very fast and pushes far away. It is of great significance to the rapid advancement of feces, causing defecation reflex, and maintaining the normal function of the colon. Group squirming generally occurs after waking up in the morning and after eating. The change of body position stimulates gastrointestinal motility after waking up in the morning, and it causes duodenal-colon reflex after eating, especially after breakfast, which makes the colon move like waves, wave after wave, setting off a peristaltic orgasm, hence the name group peristalsis Or exercise. This is why many people feel that they want to defecate after getting up in the morning or after eating.
3 What are the causes of constipation
Since defecation is a very complicated process, it requires the participation of peripheral nerves, enteric nerve plexus, spinal cord, cerebral cortex and coordinated contraction of muscles related to defecation. Any disorder in any of these links can lead to constipation, so it can cause There are many and complex causes of constipation. People group many of the causes into seven categories, and the first three causes are the most common clinically.
(1) Unreasonable eating habits and bad bowel habits.
(2) Caused by functional disorders of the colon and rectum and organic diseases.
(3) Due to mental disorders.
(4) It is caused by abnormal nerves outside the colon.
(5) Due to endocrine abnormalities.
(6) Iatrogenic constipation.
(7) Other causes, such as dehydration, lead poisoning, etc.
4 Which mental disorders can cause constipation?
Humans are animals with thoughts and emotions. Some of their mental and psychological factors can cause constipation, such as depression, anxiety, emotional tension, high concentration, obsessive thoughts, etc., which can lead to neurological disorders of the cerebral cortex and gastrointestinal tract. It can also cause constipation by inhibiting the innervation of peripheral autonomic nerves to the colon, rectum and pelvic floor.
5 Which colorectal dysfunction can cause constipation
The common conditions that cause colon and rectal dysfunction are gastrointestinal dyskinesia, weakened intestinal wall irritability, and lack of defecation motivation. The common point is that although the intestinal tract is very unobstructed, its ability to transport feces is weakened.
(1) Common causes of slow gastrointestinal motility: hypothyroidism, hypokalemia, taking anticholinergic drugs such as morphine, codeine, belladonna, etc., insufficient drinking water, and less fiber in food. These will slow the movement of the entire gastrointestinal tract and cause constipation.
(2) Reasons for the weakening of intestinal wall irritability: Mainly seen in the frequent use of stimulant laxatives, such as laxatives containing traditional Chinese medicine rhubarb, which makes the nerve receptors in the intestinal wall fatigued due to excessive stimulation, and the result is re-exposed When stimulated, it is not sensitive to stimulation and can not effectively move the bowel. This is one of the reasons why many patients with constipation take laxatives, which are effective for the first time but gradually become ineffective after regular use.
(3) Common causes of lack of defecation motivation: the elderly, infirm, chronically ill and physically weak, due to the weakened contraction ability of their abdominal muscles, diaphragm muscles, levator ani muscles, and intestinal wall muscles, so that the power to squeeze stool is insufficient, and the rectum The internal pressure cannot reach a certain level, or the internal rectal pressure is less than Bui or equal to the pressure of the anal canal. As a result, stools are not easily discharged and constipation occurs.
6 What are the organic colorectal diseases that cause constipation?
Some organic diseases of the colon and rectum can also cause constipation, such as lax intussusception of rectal mucosa, spasm of pelvic floor, incomplete intestinal obstruction, protrusion of the rectum in women, intestinal tumors (benign and malignant) and some surgical operations Sequelae (intestinal stenosis, adhesions, etc.). These diseases that occur in the colon and rectum have in common that a certain part of the intestine becomes less unobstructed. Although the intestinal function is generally not problematic, the stool is very laborious and takes longer to pass through the diseased part of the intestine. , The moisture in the feces is excessively absorbed, and the feces are dried, resulting in constipation.
Clinically, intestinal dysfunction constipation is more common, and it is often due to both functional and organic reasons. They are entangled and it is difficult to distinguish constipation caused by dysfunction or constipation caused by organic reasons. .
7 How high is the incidence of constipation?
In China, the incidence of constipation is about 3.7%, and as people’s pace of life accelerates, there is a rising trend. From a global perspective, the incidence of constipation in developed countries is even higher. The survey result in France was 6.3%; in the United States, from 1957 to 1985, 100,000 people were surveyed each year, and the incidence rate was 29%. In addition, the incidence of constipation increases with age. Data shows that the incidence of constipation is 4.5% for people 65 to 74 years old, and 10.2% for people over 75 years old. The incidence of constipation increases with age. Experts believe that due to age, people’s food intake and physical activity decrease, gastrointestinal secretions decrease, colonic tension and peristalsis are weakened, and ATZ epithelial sensitivity is reduced. Caused by a combination of factors such as a decline in the degree.
8 What is ATZ epithelium? What does it do?
At the junction of the human rectum and the anal canal, there is an irregular transition zone with a width of about 10 mm between squamous epithelium and columnar epithelium, called the rectal nautilus transitional epithelial zone, that is, the ATZ epithelial zone. The ATZ epithelium acts as a sensor. It is sensitive to pressure, gas, liquid, and solids from the rectum. When stool enters the rectum, the pressure in the rectum and anal canal increases, and the ATZ epithelium feels this pressure change. sense
The sensory nerve transmits the signal of this change to the brain to produce defecation and finally complete defecation under the coordination and command of the brain. Therefore, this sensory function of ATZ epithelium is very important. When this sensory function declines, it may affect defecation function.
9 Is there a gender difference in the occurrence of constipation?
The prevalence of constipation is different between men and women, that is, there are gender differences in the occurrence of constipation. The prevalence of constipation in women is significantly higher than that in men, and the ratio of men to women is 1:2.75. There are three reasons for this.
(1) Due to the different reproductive anatomy structure of women, the incidence of rectal protrusion is significantly higher than that of men, especially in menopausal women. The incidence of rectal mucosal prolapse in women is also higher than that in men, all of which make the excrement of feces disregarded. Chang (exit obstruction), which leads to constipation for a long time.
(2) The proportion of women suffering from irritable bowel syndrome is higher than that of men (male to female ratio is 1:2), which may be related to women’s mood swings, high work pressure, and less exercise. As a result, the intestinal dysfunction is caused. constipation.
(3) Hormonal changes in women's menstrual cycle affect intestinal transit function, and can also cause constipation.
10 Is frequent bowel movement also the cause of constipation?
Tolerance often can cause constipation. Physiologically speaking, food residue stays in the descending colon and sigmoid colon for a long time, which is mainly to facilitate the intestinal tract to absorb the water therein, so that the stool is formed. Generally, there is no stool in the rectum. The nerves in the rectal wall are more sensitive to pressure, and the pressure generated by the amount of feces more than 25 ml entering the human rectum can cause bowel movements. However, defecation is a reflex action, part of it is random that can be controlled by human consciousness, and part of it is involuntary. Humans are also social, and they cannot urinate and defecate wherever they have the intention like animals do. They often need to defecate physically but objectively they are temporarily not allowed to defecate. At this time, they have to rely on consciousness to suppress defecation and endure. , The sensation of stool disappears, the stool in the rectum can return to the sigmoid colon, and its water content continues to be absorbed, and the stool becomes drier and dry. When you defecate, it will become dry or secretive, so it is best not to bear the stool. It can be said that frequent patience is also a bad lifestyle habit.
11 What are the causes of constipation in Chinese medicine?
Traditional Chinese medicine has a long history of understanding constipation. It has been concluded that there are four major causes of constipation, namely, six exogenous emotions, internal injuries and seven emotions, improper eating and physical fitness, which are described below.
(1) Exogenous six kinks: Chinese medicine refers to the natural wind, cold, heat, dampness, dryness, and fire as the six qi. If the six qi is too much to cause disease, it is called the six kinks, because it is from outside the human body (natural ) It invades the human body and causes disease, so it is called "exogenous six evils". Wind and cold evil qi invades the human body to transform heat, or summer heat, dry heat, and fire toxin evil qi invades the human body. The evil heat combines with the dregs in the gastrointestinal tract and causes constipation.
(2) Internal injury and seven emotions: anger, joy, thinking, sorrow, worry, fear, and shock are the seven emotions of human beings. Gu Hua, which is called "seven emotions" in Chinese medicine. Excessive emotions can damage the internal organs, such as: anger injures the liver and causes liver qi to be disordered, worry injures the spleen and stagnation of qi in the spleen and stomach, grief and anger hurts the lungs and congestion of qi, etc., all of which can lead to stagnant qi in the large intestine and conduction Unfavorable and constipation.
(3) Irregular diet: Irregular diet refers to a preference for certain types of food or uncontrolled diet, such as overeating fat and sweet taste, drinking strong alcohol, eating spicy food, or taking some supplements and drugs. These damp and hot substances are easy to accumulate food and heat in the stomach and intestines, and the evil heat entering the large intestine can heat the dregs in the intestines into dry feces, which is difficult to make constipation.
(4) Excessive physique: Excessive physique refers to the partial prosperity and decline of the human body's congenital physique. For example, some people are congenital yang prosperous and easy to get angry, some people are congenital yin deficiency and less fluid, and others are congenital spleen deficiency and defecation. In addition, serious illnesses, chronic illnesses, women's postpartum, aging and infirmity, insufficient blood and energy, unable to promote the discharge of dross in the intestines, these people with prosperous and weak physiques may develop constipation with excessive heat and yin deficiency in daily life. , Qi stagnation constipation, Qi deficiency constipation, etc.
The etiology of constipation in traditional Chinese medicine is a valuable experience summed up from a large number of clinical practices, and has the most direct guiding significance for the treatment of constipation.
12 How many types of constipation are there?
The classification of constipation was messy in the past, such as primary constipation, secondary constipation, habitual constipation, spastic constipation, rectal constipation, and so on. In recent years, with the in-depth study of the anatomy, physiology, and anorectal dynamics of defecation organs, the causes of constipation have been relatively clear. Therefore, constipation is currently divided into three types in clinical practice, namely the slow colonic transport type. (Also called slow colonic transit) constipation, outlet obstructive constipation, slow colonic transit plus outlet obstructive constipation.
Colonic slow transit constipation is mainly caused by functional disorders of the colon and rectum. Outlet obstructive constipation is mainly caused by organic diseases of the colon and rectum. The cause of slow colonic transit plus outlet obstruction type constipation is both. This classification method of constipation generally clarifies the cause of constipation, makes the treatment basically targeted, improves the effective rate of treatment, and reduces the blindness of treatment.
13 What are the common clinical manifestations of constipation?
The clinical manifestations of constipation are dry or hard stools, difficult to discharge, once a few days, sometimes accompanied by bad breath, bad breath, fullness and pain, lumbosacral tail swelling and discomfort. In addition, severe constipation can also be combined with fecal incarceration, fecal stone disease and so on. The so-called fecal incarceration is a large amount of hard fecal block impacted in the rectum and cannot be discharged. The patient is suffering from abnormal pain, which can be clearly diagnosed through digital rectal examination. Stool lithiasis is a spherical, hard fecal mass formed by calcification of foreign matter in the feces that stays in the digestive tract for too long, which is like a stone, hence the name feces.
14 What harm does constipation do to the human body?
Constipation is not a serious disease, but it is very harmful to the human body and can sometimes be fatal. The main hazards of constipation to the human body are the adverse effects on the various systems of the human body, mainly in the following four aspects:
(1) Effect on the cardiovascular and cerebrovascular system: Due to constipation, they will struggle hard during defecation, which is a very dangerous thing for people with cardiovascular and cerebrovascular diseases. If you suffer from hypertension, the blood vessels themselves have hardened and become brittle. Forced defecation will increase blood pressure and cause cerebrovascular accidents. If you have coronary heart disease, forceful defecation will increase the burden on the heart, or aggravate the condition or cause sudden death.
(2) Impact on the digestive system: long-term constipation can cause loss of appetite, abdominal pain, and bloating; constipation can cause anal fissures and hemorrhoids or aggravate the original anorectal diseases. Others believe that long-term constipation can increase the risk of bowel cancer.
(3) Effects on the nerve-endocrine system: After constipation, dry and hard stools remain in the colon and rectum for a long time, which can cause the nerve-endocrine system to malfunction and cause a series of neurological reflex symptoms such as dizziness, Headache, fatigue, upset, insomnia, bad temper, acne on the face, etc. This is what we often say "the stool is dry and gets angry".
(4) Special effects on women: In addition to the above-mentioned conditions, the effects of constipation on women are also special conditions for women, that is, menstrual disorders, retroverted uterus, and old appearance are caused. Due to constipation, the rectum is over-filled with feces, pushing the cervix forward, and the uterus tilts back and presents a posterior uterine tilt, which causes women's menstrual disorders and menstrual lumbosacral pain.
15 What is the principle of treating constipation?
In principle, constipation can be divided into basic treatment and drug treatment. When the basic treatment fails to achieve the goal, drug treatment is given. Basic treatment is also a method to prevent constipation, that is, intervention and conditioning from lifestyle, diet, exercise, etc., to achieve the purpose of smoothing stool. The principle of drug treatment is to choose different types of laxatives according to different situations. All types of laxatives should be used in conjunction with each other, and do not use one for a long time.
In the drug treatment of constipation, the basic treatment should not be abandoned, but should be run throughout, because the basic treatment is treatment without any toxic side effects, and more importantly, the basic treatment can prevent the occurrence of constipation and is a permanent cure.
16 How many types of laxatives are there?
Drugs that can regulate stool, treat constipation, or have a laxative effect can all be called laxatives. There are many types of laxatives. According to their mechanism of action, many laxatives are generally classified into four types in clinical practice, namely, gastrointestinal motility agents, laxatives, stool softeners and moisturizing laxatives. Generally speaking, the mechanism of action of western medicine laxatives is relatively specific, while the mechanism of action of traditional Chinese medicine laxatives is more complicated. Sometimes a traditional Chinese medicine compound preparation can have several different mechanisms of action, so the traditional Chinese medicine laxatives are not good. Category, especially compound preparations.
17 Which drugs are gastrointestinal motility agents?
Gastrointestinal motility agents are total gastrointestinal prokinetic drugs that can promote gastrointestinal peristalsis, and have a good effect on chronic constipation caused by slow transit constipation of the colon and chronic constipation and idiopathic constipation caused by long-term abuse of laxatives. Domperidone domperidone, cisapride, and Prebos in western medicine, Muxiang Shunqi Pill, Mu Champagne Lang Pill, Qi Stagnation Granule, etc. in Chinese patent medicine are all gastrointestinal motility agents. In clinical practice, only relying on gastrointestinal motility agents (especially western medicine) has poor laxative effect, and needs to be used in conjunction with other laxatives.
18 What is a laxative? What drugs are included?
Any medicine that can cause diarrhea and discharge hard stools is called a laxative. Laxatives are divided into volumetric laxatives (also called volumetric laxatives) and stimulant laxatives.
Volumetric laxatives are some salt ions that are not easily absorbed by the intestinal wall but are easily soluble in water. After taking them, they form a hypertonic salt solution in the intestine. On the one hand, they prevent the intestinal tract from absorbing water in the intestinal cavity. It also absorbs a large amount of water from the intestinal wall tissue, resulting in increased water in the intestinal cavity and increased volume, which exerts pressure on the intestinal mucosa or intestinal wall. After the intestinal wall feels this strong pressure, the movement of the intestinal canal is enhanced through nerve reflex. As a result, stool is discharged. Magnesium sulfate, sodium sulfate, methyl cellulose, 20% mannitol injection, and Chinese medicine Glauber's salt in western medicine are all volumetric laxatives. Stimulant laxatives are the use of certain drugs or their metabolites in the human body to directly stimulate the nerve receptors in the intestinal wall, reflexively enhance intestinal peristalsis, thereby promoting stool excretion. Western medicine castor oil, phenolphthalein, Chinese medicine aloe, rhubarb, and senna are all irritant laxatives. The stimulant laxative of traditional Chinese medicine is also the most widely used laxative in clinical practice.
19 What is a stool softener? Which drugs are included
Any medicine that can smooth the intestinal wall, soften the stool, and make the stool easier to pass out of the body is called a stool softener. Such as liquid paraffin, keratin, sesame oil, and oil-rich nuts in traditional Chinese medicine such as hemp kernels and cypress kernels are all stool softeners. The function of stool softener is to lubricate the intestinal wall, so except for traditional Chinese medicine, most of them introduce a certain amount of medicine into the rectum to lax, so it is suitable for various types of constipation, including fecal impaction. Not restricted by age, gender and physical strength.
20 What is a wetting agent? What drugs are included?
Wetting agents are also called moisturizing laxatives. They are some surfactants with softening effects. They can reduce the surface tension of feces and make it easy for water to soak into human feces, causing feces to swell, soften, and be easily excreted. Western medicine docusate sodium, traditional Chinese medicine honey, hemp, Wangxiang pills, etc. can be classified as wetting agents. Moisturizers are mainly suitable for constipation of the elderly and physically weak, constipation of pregnant women and those with partial bowel movements, and their diarrhea effect is mild. Severe constipation and young adults with constipation have poor results.
21 Is the treatment of constipation the choice medicine or western medicine?
In the treatment of constipation, traditional Chinese medicine and western medicine have their own strengths, but the effect of western medicine laxatives is relatively simple, or gastrointestinal motility agent, or laxative, etc., while traditional Chinese medicine is different. Chinese medicine laxative function is mostly compound type , Is a gastrointestinal motility agent, but also has a purgative or smoothing effect, so the effect of choosing a laxative to treat constipation is better. There are two advantages of the traditional Chinese medicine laxative: one is low price; the other is the mechanism of action is not single, and it is not easy to appear that the treatment effect is getting worse. Most of the laxatives currently on the market in China are traditional Chinese medicine preparations, especially the compound preparations of rhubarb and aloe. It can be said that in the treatment of constipation, Chinese medicine occupies a dominant position.
22 Constipation, once a few days, how to use medicine?
For constipation, it is more painful for patients with constipation to relieve the stool once a few days, and the time for each bowel movement is more than 30 minutes. In accordance with the principle of TCM, "the emergency is to treat the symptoms, and the slow is to treat the root cause", the stool should be cleared first, and then the cause will be treated. The treatment method is to take a volumetric laxative such as 250 ml of 20% mannitol first, and then drink 500 ml of boiled water. Generally, you will have a strong sense of bowel movement in about 1 hour. If there is no movement after one and a half hours, you can take it again. This type of constipation can also be taken with 8-10 grams of Chinese medicine Glauber's salt or Sodium Sulfate powder and drink a lot of water (about 1000 ml), and the stool will clear in about 1 hour.
After the patient clears the bowel movement, he can take Maren Runchang Pills every day for maintenance (take according to the instructions), drink more water and eat more vegetables, gradually establish good bowel habits, and then remove the drug.
This kind of constipation is also very good according to traditional Chinese medicine to decoct herbal medicine, such as Dachengqi Decoction, one dose per day, and two jingjiang can be effective. Some patients are busy with work and cannot be treated according to the above requirements temporarily. You can take 1 pill of Niuhuang Jiedu Pill or take Niuhuang Jiedu Pill twice. Elderly and frail people should not use more doses, and should still be taken as usual.
23 Stool once every two days, the stool is dry, how to use medicine
In this case, if the constipation is more serious, it should be lighter. You can take stimulant laxatives to relieve stool first, such as Niuhuang Jiedu Pills, Niuhuang Jiedu Tablets, Aloe Capsules, etc., and you can take them according to the drug instructions. The bowel movement for the first time after taking the medicine is often a little dry, and it is better to use 20ml of Kaisailu together. Adhere to diet and physical exercise (basic treatment) after the stool is unblocked. This kind of situation can also be treated with dietary conditioning plus Kaiserol method, which is based on diet of fruits and vegetables, physical exercise, but externally use 20ml Kaiserol to lubricate the intestines before each bowel movement, and then go out according to the situation. Remove Kaisailu gradually. You can also ask Chinese medicine doctors for treatment based on syndrome differentiation.
How to use Kaisailu: Lie on the bed before defecation (left side or right side), hold 1 bottle (20ml) of Kaisailu from the anus and lie down for 1-2 minutes You can go to defecate. There is no pain in the external application of Kaiserulin to stool.
24 It's just that the stool is dry, how to use medicine?
The stool quality is a little bit drier than normal, and the defecation time is prolonged. This situation is clinically common.
If the patient is a young person, especially a young woman, most of them have a common feature, that is, they drink little water, the tongue is red, the coating is thin and white, or there is little coating. This belongs to the yin deficiency constipation of traditional Chinese medicine. If there is a smell in the mouth, it is Cassowary. It is good to treat simple Yin deficiency constipation with softeners and moisturizers, such as taking Ma Ren Zipi Pills, Ma Ren Runchang Pills, or drinking honey water. Pay attention to the honey water to be thicker, too weak to pass. Stool effect, in addition, eat more vegetables and drink more water, the large intestine is moisturized by water, and the feces can naturally be discharged smoothly. For those with cassava, on the basis of taking Maren Runchang Pills, or adding Niuhuang Jiedu tablets, or adding Baohe Pills, Betel Nut Sixiao Pills, etc.
If the patient is an elderly person, there is often an outlet obstruction. If the syndrome is constipation due to deficiency of Qi according to TCM, you can take Buzhong Yiqi Pills, but it is better to be treated by decoction of herbal medicine or injection by anorectal physician. The effect is better. If the patient is fatter and the muscles are loose, it means that the rectal mucosa is prolapsed, which makes it difficult to pass stool, and injection is better.
25 Uncomfortable stools, what's wrong with the feeling of unclean stools? How to treat?
Many people, especially middle-aged people, do not have dry stools, but they feel uncomfortable with their stools. They always feel that they have not cleared their stools. Chinese medicine believes that this is due to heat and dampness in the large intestine: damp-heat and pathogenic qi block the qi stagnation in the large intestine, which makes it uncomfortable to get rid of it; the damp stickiness is difficult to get rid of. The treatment method is: Oral Muxiang Shunqi Pills or Binglang Sixiao Pills to clear the stagnant qi in the large intestine and remove the damp heat of the large intestine. Those who have greasy tongue coating are more humid and hot, add bezoar detox tablets. If the treatment effect is not good according to this method, you should go to the hospital for examination. Such patients often suffer from rectal protrusion, rectal mucosal laxity, which is an outlet obstruction. Difficulty in defecation caused by outlet obstruction is not effective with oral medication. At present, the best way to treat the difficulty of defecation caused by outlet obstruction is the injection method: routine disinfection of the anus, Xiaozhiling injection and 0.5% lidocaine injection are prepared at a ratio of 1:1, and the medicine is prepared under anoscope Inject into the loose rectal mucosa, with fullness as the degree, neither too deep nor too shallow. The treatment must be performed by an anorectal physician, and there is no risk if the operation is correct.
26 What's wrong with sticky stools and uncomfortable stools?
In clinical practice, some patients have stools that are not dry, but they are sticky and uncomfortable. They always feel that the anus is not clean after defecation, and it is still very laborious during defecation. This type of patients belongs to the spleen-dampness block of the large intestine qi machine, and the two aspects of the problem are the unpleasant and unclean feelings mentioned above: the former is uncomfortable but the stool quality is not sticky, and it is damp-heat blocking the qi machine; In this card, the stool is uncomfortable, the stool quality is obviously sticky, and there is always the feeling that the stool sticks to the intestinal wall and does not come down. The difference between the two certificates is that one has heat, the other has no heat, and even has cold signs. In terms of treatment, the treatment of this syndrome is to warm the spleen and stomach, dissipate dampness and turbidity, regulate qi and relax. According to the patient's tongue coating and pulse condition syndrome differentiation prescription, ginger, dried ginger, cumin, clove, huoxiang, black medicine, etc. warm the spleen and stomach, reduce dampness The drugs can be used. There is no Chinese patent medicine that is consistent with this syndrome. You can take Xiangsha Yangwei Pills, Muxiang Shunqi Pills, or Baohe Pills and Binglang Sixiao Pills. If the disease is mixed with dampness, it will be lingering and difficult to heal, so it takes longer to take the medicine.
27 Why does the stool become soft after being dry?
Many people have stool that is dry or even spherical, but then the stool is soft or even loose, so it is still very uncomfortable at the beginning of each bowel movement. People with such symptoms may have hemorrhoids (mainly internal hemorrhoids) or loose or intussusceptible rectal mucosa. The pressure in the anal canal of patients with hemorrhoids is increased; therefore, when there is only a small amount of feces (below 50ml) in the rectum, the pressure in the rectum is lower than the pressure in the anal canal, and the rectal wall does not feel effective pressure and there is no sense of stool. ; The same principle, the resistance of rectal mucosa is increased when the rectal mucosa is loose and intussusceptible. When the amount of stool is small, the pressure in the rectum is less than the resistance caused by the loose and invaginated mucosa, and there is no sense of defecation. The result of these two situations is that regardless of whether the residual stool in the rectum returns to the sigmoid colon or is still in the rectum, its water content must be absorbed by the intestines, so when you defecate, the stool will dry first and then soften. It is normal stool, and dry stool is stubborn stool. This kind of situation should be checked first to confirm the diagnosis before treatment: patients with rectal mucosal prolapse can be treated with anorectal injection, band ligation, etc.; patients with hemorrhoids can be treated with internal hemorrhoid ligation. Those who do not wish to undergo surgery can use oil-containing suppositories such as Taining Suppository and Rongchang Kangtai Suppository for external use. They have the function of smoothing the intestinal wall and facilitate the passage of feces with reliable curative effect. If the effect of external suppositories is poor, you can use Kaisailu 1 to support the stool. You can also take Muxiang Shunqi Pills plus Sanhuang Pills daily by taking Muxiang Shunqi Pills 2 times a day, 6 grams each time, and taking Sanhuang Pills at the same time, 3 tablets each time.
28 Can constipation be treated surgically?
For patients with severe chronic constipation, after a period of rigorous non-surgical treatment, there is still little effect. Various special examinations have shown clear pathological anatomy and conclusive intestinal functional abnormalities. Surgical treatment can be considered.
Surgical treatment of constipation is based on different causes. Surgical treatments for colonic slow transit constipation include subtotal colon resection and partial colon resection; for outlet obstructive constipation with rectal protruding anterior bulge repair Or use Xiaozhiling and other sclerosing agents for injection; for mixed hemorrhoids, perform external chop and internal ligation or internal hemorrhoid ligation for milder external hemorrhoids.
Although surgery is effective for constipation, some complications or other conditions may occur, so be careful when choosing surgery.
29 How does Chinese medicine treat constipation?
According to the clinical manifestations of constipation, traditional Chinese medicine conducts syndrome differentiation and treatment, and generally divides constipation into four syndrome types: heat constipation, qi constipation, deficiency constipation, and cold constipation.
(1) Heat secretion: constipation due to excessive heat in the stomach and intestines. It is characterized by constipation, obstruction for several days, full abdominal pain, and hot breath. Use traditional Chinese medicine Dachengqi Decoction or Niuhuang Jiedu Pills and other medicines that can cause severe heat and heat.
(2) Qi constipation: constipation due to stagnation of liver and spleen qi. It is characterized by dry stools, uncomfortable chest and abdomen and flanks, and depression. It can be treated with medicines such as Liumo Tang, Muxiang Shunqi Pills, Binglang Sixiao Pills, and Danggui Longhui Pills (1 pill each time, 3 times a day) and other drugs for smoothing Qi and stagnation.
(3) Deficiency: Deficiency constipation has two fecal types: Qi deficiency constipation and Yin deficiency and blood deficiency constipation. Qi-deficiency constipation is the deficiency of both lung and spleen. It is characterized by having stool once every few days, but little discomfort in the abdomen, general fatigue, and shortness of breath during the stool. It can be treated with Chinese medicine Buzhong Yiqi Pills and Maren Runchang Pills. Blood deficiency constipation is more common in people with aging hands, physical weakness, and postpartum. It is characterized by difficulty, weight loss, pale complexion, and shortness of breath. Treatment should focus on supporting the righteous qi and replenishing qi and blood, and moistening the bowel and laxative. It can be treated with Chinese medicine Zuogui Pill, Bazhen Pill, Ejiao Buxue Ointment and other medicines combined with Ma Ren Runchang Pills.
(4) Cold secretion: constipation due to yang deficiency of the spleen and kidney, which is more common in people who are weak and old. Yang deficiency produces internal cold, cold viscera and astringent airway, cold in the large intestine, solidified stool, and cold secretion. It is characterized by stools once a few days, dryness and difficulty, and cold limbs. It is better to use the traditional Chinese medicine Jinkuishenqi Pill or Yougui Pill to warm and nourish the kidney yang. It is better to use Kaisailu during defecation. It can also be used with oral Maren Runchang Pills or drink honey water.
30 Why is the stool still dry after taking laxatives?
Many constipation patients still have dry stools after taking Niuhuang Jiedu Tablets or Maren Runchang Pills. There are three reasons for this.
(1) Constitutional reasons: mostly Yang-wang constitution or Yin-deficiency and fire-wang constitution. People with this type of physique need water to moisturize, so in addition to taking medicine, they should drink more water, eat more fruits and vegetables to cooperate with the treatment. Generally, it will have a significant effect after one week.
(2) Insufficient dosage: the power of purging medicine is slow and severe. If Niuhuang Jiedu tablets are taken 3 times a day, 4 tablets each time, it will be effective for the average person. However, the effect of Sanhuang Tablets is slightly worse when used in this way, and sometimes it needs to be increased. Maren Runchang Pills are for many young people. It is said that the effect of taking 2 pills a day in a regular dosage is average, and it is necessary to increase the dosage or take a small amount of Niuhuang Jiedu tablets to obtain significant effects.
(3) Decreased intestinal nerve sensitivity: The myenteric plexus of the colon and rectum is sensitive to the pressure on the intestinal wall and the stimulation of the active ingredients of laxatives, but frequent use of stimulant laxatives will reduce the sensitivity of the nerves , Resulting in so-called drug resistance. At this time, giving the same laxative will not produce a laxative effect, but should be changed to volumetric laxatives or other laxatives to be effective.
31 Why not take a laxative?
It is okay to take medication for constipation, but it is often not appropriate to take only one laxative. First of all, the medicine is three-point poison. No matter which type of laxative, it has certain side effects on the body, so no matter which type of laxative, do not take it frequently. The treatment of constipation should also be based on diet, and to develop good living habits. Medications should only be used for temporary pain and should only be used occasionally. In addition, regular use of a laxative to maintain defecation will lead to decreased intestinal mucosal irritability and decreased sensitivity of the nerves of the intestinal wall, which can cause chronic constipation. Therefore, do not take a laxative, let alone a certain type of laxative.
32 How about frequent enema?
Nowadays, there is a kind of intestine washing machine, which is said to be able to remove toxins, freckle, and nourish the skin. It is very popular among women. In fact, whether it is good for detoxification or beauty, the main thing is to rely on a reasonable diet and nutrition and good living habits. It is not an appropriate choice to rely on the intestine washing machine to maintain health.
Of course, it is good for health to do a clean enema every month or quarter, but do not use soapy water for enema. We think it is best to use normal saline for intravenous drip, and the dosage is 500-1000 each time. Milliliter, clean, hygienic, can also get rid of stools and is economical without any pain.
33 What is the principle of preventing constipation?
The two principles of preventing constipation refer to the two principles we must master to prevent constipation in daily life. The first principle is to maintain a good mental state, a cheerful personality, a comfortable mood, and an optimistic attitude towards life. It is necessary to avoid unhealthy emotions and mentality such as tension, depression, anxiety, sentimentality, pessimism, disappointment, moodiness, etc., because changes in people's "seven emotions" can cause disorders of gastrointestinal nerve function and inhibit gastrointestinal motility and cause constipation. The second principle is to adopt a lifestyle that conforms to gastrointestinal passage and defecation exercise, that is, to develop a good lifestyle. It can be said that the occurrence of constipation is directly related to a bad lifestyle.
34 What are the aspects of a good lifestyle?
A good lifestyle mainly includes four aspects, namely daily daily life, diet regulation, scientific defecation, and physical exercise. These four aspects should be organically combined, and should not be artificially separated in daily life, and should not be biased or discarded. In clinical practice, we have encountered many patients with constipation, all of which have gradually developed constipation because they have neglected one of these four aspects in daily life. Therefore, constipation can be prevented effectively only by fully paying attention to these aspects. In addition, a good lifestyle requires persistence, and it should be developed into a behavior habit.
35 How to prevent constipation in daily life?
Be regular in daily life. Human beings have gradually formed a biological clock that conforms to nature during their long-term reproduction, which is actually a kind of life law. Everyone has their own rules of life, such as when to get up, when to work, when to eat, when to sleep, etc. Don't change this rule easily, because the various systems of the human body are working step by step according to this rule Running. If you frequently change your life habits and break the rules of life, the functions of the body's various systems will be in a state of disorder. Often disorder, beyond the body's ability to adjust will lead to disease. The most common diseases caused by disorders of the gastrointestinal system are constipation and indigestion. Therefore, you should arrange your life well and form a regular pattern. This is the basis for ensuring your health.
36 How to prevent constipation in terms of diet?
The effect of preventing constipation from diet is the most direct, and the following three points should be adhered to in daily diet.
(1) Increase dietary fiber: This is also the so-called food therapy. Medication is not needed if diet therapy is possible. Experiments have proved that adding 30 grams of dietary fiber to food every day has a clear laxative effect after half a month. Vegetables and fruits are rich in crude fiber. According to the information received from patients and our experience, apples, celery, water spinach, amaranth, leeks, Chinese cabbage, water chestnuts, etc. have better laxative effects, so it is recommended to eat more vegetables and fruits. To increase dietary fiber. It is better for adults to eat more than 500 grams of vegetables and fruits per day.
(2) Do not eat or eat less spicy and hot foods: From the perspective of traditional Chinese medicine, spicy and hot foods can produce damp heat and help fire poison. Tormenting large intestinal fluid with hot toxins can lead to dry intestines and constipation. It can make stool uncomfortable, so eat less or not eat this kind of food.The foods that can generate heat and heat to help the fire mainly include pepper, white wine, beef and mutton, dog meat, barbecued food, fried food, etc. (3) Drink more water: The principle of increasing the amount of drinking water is the same as increasing dietary fiber. They can increase intestinal capacity, stimulate gastrointestinal motility and facilitate defecation. Adults should not drink less than 1000ml of water per day, especially if they drink a glass of cold water after getting up in the morning, and then do some activities, they can stimulate bowel movements, especially group movements, which can quickly produce bowel movements, which is to maintain normal bowel movements. The simplest and cheapest method.
37 What are the exercise methods to prevent constipation?
Regular physical activity can promote or strengthen the functions of various tissues and organs of the body. In order to prevent constipation, you can consciously do some exercises to increase the strength of the abdominal muscles and intestinal muscles, because they help intestinal peristalsis and promote defecation. There are several exercise methods to increase the strength of the abdominal muscles and intestinal muscles. Patients can choose one or more according to their own conditions.
(1) Running: Running is a very good sport. The elderly can jog or take a walk. The distance of each jog is 2-3 kilometers, and the walking distance is about 5 kilometers.
(2) Sit-ups or two heads up: This is an exercise program dedicated to exercising abdominal muscles. The method of raising both ends: Lie on your back on the bed, relying on your hips, raise your upper body and lower extremities at the same time with the strength of your abdominal muscles, touch the upper and lower extremities in the air, and then put them down again in a supine position. Sit-up method: Lie on your back on the bed, keep your hips and lower limbs still, rely on the strength of your abdominal muscles to make your upper body sit up at a right angle to your lower limbs, and then lie down on your upper body once again in a supine position. You can choose one of them or alternate exercises according to your own situation. Every 10 times is a group, and you can do 3-5 groups a day for unlimited time.
(3) Abdominal breathing or belly-up: Abdominal breathing: sit upright, close your eyes, cross your hands and fingers under the umbilicus, undress and untie, and take deep breaths. When you breathe in, Mind leads the clear air into the nose and lowers it under the navel, while the abdomen bulges. When you exhale, Mind leads the muddy breath out of the mouth, and at the same time retracts the abdomen once. Doing 100 times a day or doing abdominal breathing for 10 minutes a day can increase the strength of the abdominal muscles and increase colon movement. The exercise time is better after the morning.
Everyone knows how to do abdominal push-ups. This is the way to exercise your chest and abdominal muscles. Do 30 to 50 abdominal push-ups every day, and you have free time.
(4) Sports gymnastics: Radio gymnastics also has a good fitness effect, among which abdominal and back exercises have the effect of significantly enhancing the strength of the abdominal muscles. In addition, the lower waist and active waist and hips also have the effect of strengthening abdominal muscles and promoting colonic peristalsis. Do it for 10 minutes every day. Japanese scholar Uchida Yoshihide believes that abdominal muscle weakness is the main cause of constipation, so he created a V-shaped gymnastics, which is said to be effective. The method is very simple, that is, touch your hips and hands on the ground, lean your upper body back, raise your legs parallel to your eyes, and hold for half a minute.
38 How to prevent constipation through self-massage?
If you don't have time for sports, you can do self-abdominal massage from time to time every day, which is also very effective in preventing and treating constipation. The four self-massage methods are introduced below, all in a standing position, and the massage time is unlimited.
(1) Clockwise massage: With the umbilicus as the center, place the left and right hands overlapped beside the umbilicus, massage the abdomen in a clockwise direction, and massage the entire abdomen as much as possible. This method can help colon movement.
(2) Horizontal massage: place both hands on the top and bottom of the belly button, and massage the abdomen horizontally. This method can stimulate the abdominal muscles and colon.
(3) Tuina lower abdomen: place the left and right hands on the liver flexure of the colon and the splenic flexure of the colon respectively, and then squeeze the lower abdomen with strong downwards and do it repeatedly. This method helps the colon push down the stool.
(4) Beat the lower abdomen: Make a fist with both hands, beat the lower abdomen forcefully, bulge the abdomen when the fist is in contact with the abdomen, and exhale quickly and make a shout. Do it once every morning and beat the abdomen 100 times each time. This method has great stimulation to the abdominal muscles and colon, and the effect is better.