Old Wang came to see constipation, although various tests have not found any major problems, but more than half a year to eat more and more fruit guide tablets, and now need 10 capsules a day to defecate, this is very distressed. When asked, it turns out that Wang has been buying laxatives to help defecate for several years.
Like the old king does not care too much about why they will be constipated a lot of people, usually “forget the pain”, constipation attacks with corkage or laxatives to solve, but after a while constipation will still occur.
Medication is only one aspect of the treatment of constipation, if you do not pay attention to the adjustment of lifestyle habits, the wrong use of stimulant laxatives, constipation is afraid to continue to occur, this knowledge is necessary to popularize:.
There are many types of laxatives, each with its own advantages and disadvantages, the common laxatives on the market are these categories: stimulant laxatives, hypertonic laxatives, volumetric laxatives, salt light laxatives, lubricants, etc..
There are many types of laxatives, each with its own advantages and disadvantages
1, stimulant laxatives: such drugs are fruit guide, senna, rhubarb sodium bicarbonate (rhubarb soda), etc.. They stimulate colon peristalsis, 6 to 12h that have a defecating effect, but will produce abdominal pain, water-electrolyte disorders and other adverse reactions. Not suitable for long-term use.
2, osmotic laxatives: can form a hypertonic state in the intestine, absorb water, increase the volume of stool, stimulate intestinal peristalsis, can be used for patients with mild to moderate constipation. Drugs include polyethylene glycol, non-absorbed sugars (such as lactulose) and salt laxatives (such as magnesium sulfate).
Polyethylene glycol is not absorbed and metabolized by the intestine after oral administration, and its low sodium content does not cause absorption or loss of net intestinal ions, with few adverse reactions; lactulose can be decomposed into lactic acid and acetic acid in the colon, which can promote the growth of physiological bacteria, and can be used by diabetic patients, with a mild laxative effect, slow onset of action, softening the stool so that it can be easily excreted, and can be taken for a long period of time without developing drug resistance.
Salt light laxative: such as magnesium sulfate, due to the effect of osmotic pressure will quickly increase the amount of water in the stool, half an hour later can produce sudden watery diarrhea. These laxatives can cause water-electrolyte disorders, generally in the hospital as intestinal preparation should not be used for a long time, for those with fecal impaction can be enema to eliminate feces. With renal insufficiency should not use magnesium-containing preparations.
3, volumetric laxatives: containing high molecular cellulose and cellulose derivatives, with hydrophilic and water-absorbing expansion characteristics, can make the water and volume of feces increase, promote colon peristalsis. Such laxatives are more suitable for diabetes with constipation or low residue diet of the elderly, not only laxative, can also control blood lipids, blood sugar, small side effects, can be long-term use; but the slow transmission of colon constipation caution.
4, lubricant: liquid paraffin (paraffin oil) can soften stool, can be taken orally or enema, is a milder laxative, its role is mainly to lubricate the intestinal wall, softening stool, reduce water absorption, promote intestinal peristalsis. The disadvantage of these drugs is poor taste, weak, long-term use can cause malabsorption of fat-soluble vitamins.
5, intestinal dynamics drugs: the action of the intestinal nerve endings, the release of motor neurotransmitters, effective for chronic transmission constipation, such as mosapride, cisapride. But the drug is likely to cause arrhythmias, the clinic is no longer commonly used. Tegaserod is effective for irritable bowel syndrome, constipation, especially for those who have used osmotic laxatives and volumetric laxatives are ineffective.
Stimulant laxatives should not be used for a long time
In fact, like the old Wang long-term use of fruit guide, senna and other stimulant laxatives is not a lot of people, a few days can not pull, eat a few capsules of fruit guide is basically an immediate effect, a smooth. However, do not pay attention to lifestyle habits and dietary adjustments, after often the same, regular constipation, and finally to seek the help of laxatives, not to solve the problem at the root.
However, long-term reliance on stimulant laxatives to relieve constipation can lead to the patient’s dependence on laxatives or even failure. At this point, once constipated patients stop using such drugs, constipation symptoms often worsen because long-term use can damage the ganglia in the intestines leading to more stubborn constipation. There is a worse scenario that can develop, as these preparations usually contain anthraquinone, which after long-term ingestion has melanin deposits under the mucosa of the colon, forming the so-called colonic melanosis.
Constipation can be effectively treated by identifying the cause
Constipation can be divided into two categories: organic and functional. Functional constipation is mainly caused by non-organic diseases such as low food intake or lack of fiber, insufficient water intake, irregular bowel movements, colonic motility disorders (irritable bowel syndrome), old age, and drug abuse (drug dependence). The main organic causes are: tumors, congenital megacolon, diabetes combined with peripheral neuropathy, hypothyroidism, post-stroke sequelae, etc.
Most of the constipation in young patients is functional and is mainly treated by changing lifestyle habits and medication-assisted treatment.
Lifestyle changes: consume enough dietary fiber, keep exercising, hydrate enough, form good defecation habits, regulate intestinal flora, avoid using constipation-causing drugs, etc.
Drug-assisted treatment: stimulating laxatives should not be used for a long time, constipation is best treated under the guidance of a doctor, reduce the dosage of drugs or choose some laxatives such as lactulose, cellulose drugs with little side effects for long-term use.
For persistent constipation, organic lesions should be excluded, such as intestinal obstruction caused by colon cancer, redundant sigmoid colon, congenital megacolon, etc. Therefore, for patients with constipation that does not work with conventional treatment, it is best to see a doctor first and have a colonoscopy to rule out organic lesions that cause constipation, especially in middle-aged and elderly people, which can play a role in etiological diagnosis and early detection of tumors.