A, constipation is divided into
1, primary constipation: the cause is unclear, no other diseases causing constipation, so also known as idiopathic constipation.
2, secondary constipation: secondary to other diseases, is a symptom of other diseases, the original disease is controlled, constipation will be eliminated. The incidence of this type of constipation is the most, without attention to examination often leads to misdiagnosis, such as colorectal cancer caused by secondary constipation without attention to examination may delay surgery.
Second, primary constipation, also known as functional constipation, can be divided into
1, slow transmission type constipation: characterized by no bowel movement, only bloating.
2, export obstruction type constipation: characterized by stool intention, but difficult to discharge, this type of disease more, such as rectal prolapse, mucosal prolapse, pelvic floor hernia, puborectal muscle spasm or hypertrophy.
3, mixed constipation: that is, the first two types exist at the same time.
Third, need to do the following tests.
1.Colonoscopy.
2, barium enema.
3, defecography.
4, pelvic quadruple (female) or triple angiography (male)
5, anorectal manometry.
6, anorectal electromyography.
7.Colonic transmission test.
IV. Treatment
1, drug therapy: is the main means of treatment, a variety of laxative laxatives, should often be replaced, preferably not a drug commonly used continuously, because it can lead to colonic melanosis.
2, surgery: only for a small number of stubborn constipation, so such surgery is only symptomatic treatment, not etiological treatment, the indications are very strict, the surgery itself may also have complications, such as pelvic surgery can cause sexual dysfunction in men, women can cause infertility.
A, slow transmission type constipation: colonic subtotal, or total excision.
B. Double-lumen colostomy: elderly patients with intractable constipation who cannot tolerate excisional surgery.
C, STARR surgery: patients with anterior rectal protrusion and intra-rectal mucosal prolapse.
D.PPH surgery: patients with milder anterior rectal protrusion, intra-rectal mucosal prolapse and heavy internal hemorrhoids.
E.Autograft of closed-hole endomysium: those with severe pelvic floor descent.