Five issues that constipation patients must know Constipation is very common, especially in modern society, due to the unreasonable structure of the diet and its reduced activity, mental stress, etc., has become a symptom of many people’s troubles. Constipation can occur regardless of age and gender, but women, the elderly, children and post-surgical patients are the high-risk groups. China’s Beijing, Tianjin and Xi’an region on the 60 years of age or older survey shows that chronic constipation up to 15% to 20%. A randomized, stratified and graded survey of adults aged 18 to 70 years in Beijing showed that the prevalence of chronic constipation was 6,07%, with women being more than four times that of men. The following is an explanation of the five common problems of constipation that we are concerned about.
First, what is constipation?
In healthy people who consume moderate amounts of fiber food, generally defecate once a day to form soft stools, but in the low-fiber diet can be defecated once every other day, is also normal. Where the stool texture is dry and hard, difficult to defecate, loss of normal frequency, generally less than 3 times a week defecation, is called constipation.
Second, the cause of constipation?
Constipation is closely related to gender and age, so we will mainly introduce the causes of female constipation, senility and pediatric constipation.
1, female constipation: female constipation causes in addition to systemic factors, but also with the female pelvis is wide, female urogenital triangle muscle fascia weak, prone to rectal protrusion. Pregnancy and childbirth cause injury can lead to prolapse and perineal descent in the rectum. And a persistent decrease in female steroid hormones may be associated with intractable constipation. During pregnancy, progesterone secretion increases due to luteal secretion, and the latter can inhibit intestinal peristalsis and reduce intestinal irritation perception, resulting in constipation. Maternal weakness, several days of postpartum bed rest, reduced activity, intestinal peristalsis is weakened, is also a cause of constipation.
2, geriatric constipation: with the growth of the elderly, the structure of the digestive system changes, defecation function is also affected, defecation power than adults significantly decreased; elderly diaphragm, abdominal muscles, anal muscle and colon wall smooth muscle contraction ability generally decreased, gastrointestinal mucosa atrophy, reduced secretion, easy to cause dry fecal matter and discharge difficulties; elderly neurological system function is weakened, defecation reflex is slow; elderly Systemic diseases and anorectal diseases can cause constipation, and taking certain drugs can also cause constipation; in addition, the elderly lose teeth, do not like to eat coarse fiber food, lack of dietary fiber, and less activity, intestinal peristalsis generally reduced.
3, pediatric constipation: meconium constipation due to thick meconium constipation and the formation of fecal plug, difficult to discharge. Normal newborns in 24 h first defecation, such as 48 h after the absence of stool, should also exclude congenital anal atresia or stenosis, congenital megacolon, etc. can lead to pediatric constipation; pediatric functional constipation is the most common, accounting for more than 90%, and anorectal power, colonic weakness and outlet obstruction is an important reason for its occurrence; secondly, the pediatric diet is insufficient or improper, often eat fine and less dregs food, serious partiality Picky eating, etc. is an important cause of constipation.
Third, why is a balanced diet and a regular life important to prevent constipation?
A normal balanced diet not only has carbohydrates, proteins, fats, minerals and vitamins, but also contains sufficient amount of cellulose, hemicellulose, lignin and other coarse fibers. Coarse fibers increase fecal volume and effectively stimulate the intestinal tract, making its peristalsis faster and stronger, while retaining water in the intestine to avoid overly dry stools. When the food scraps (dietary fiber) is not enough or too little intake, too vegetarian can cause constipation. Some people due to irregular life or sudden changes in the living environment, work, psychological stress, or poor toilet conditions, as well as anorectal disease patients, often ignore the stool, not timely defecation, rectal mucosal stress retardation (insensitive), thus causing constipation.
Fourth, what are the commonly used laxatives?
Functions of commonly used laxatives.
(1) expansion agent: through the absorption of water, gas to change the colon flora, in order to increase the amount and volume of feces, such as bran, Ou Che Qian, methyl cellulose, etc., the effect time of such drugs 1 ~ 3 d, should pay attention to the intake of water, otherwise it does not play a laxative role.
(2) stimulating laxatives: such as senna, rhubarb, etc., by stimulating the colon to increase intestinal peristalsis, such as phenolphthalein and castor oil, etc., they also inhibit the absorption of intestinal water to soften the role of stool.
(3) osmotic laxatives: such as polyethylene glycol 4000, lactulose, sorbitol, magnesium sulfate, phosphate and other inorganic salts, which are rarely absorbed after oral administration, forming hyperosmolarity in the intestine to maintain a large amount of water in the intestine, thus stimulating intestinal peristalsis to promote defecation.
(4) Laxatives: liquid paraffin can make stools easy to pass by lubricating the intestinal wall.
(5) enemas and suppositories: mainly glycerin (suppositories) and soap and water, which directly stimulate the intestinal wall and reflexively promote intestinal peristalsis, resulting in the excretion of stools
(6) drugs affecting gastrointestinal motility: cisapride, mosapride, to enhance gastrointestinal motility, slow passage type constipation has a certain effect.
Five, often take laxatives for constipation of the harm?
1, constipation patients generally like to use laxatives to help diarrhea, in fact, long-term use of laxatives, not only does not help the improvement of constipation, and can cause more serious constipation, and bring all kinds of adverse consequences;.
2, stimulating laxatives commonly used are rhubarb, senna, phenolphthalein and castor oil, etc.. Rhubarb, senna contains anthraquinone, long-term use, can make the colon mucosa deposited a large amount of melanin, causing colonic melanosis, some domestic scholars believe that colonic melanosis has the tendency to malignant transformation. In addition, stimulating laxatives can also cause severe abdominal cramps, long-term use can lead to water-electrolyte disorders and acid-base imbalance, when used regularly for many years, it can cause “diarrheal colon”, and often diagnosed as stubborn constipation, so the administration of more laxatives or other improper treatment resulting in adverse consequences.
3, long-term application of salt laxatives, severe diarrhea can lead to dehydration.
4, inappropriate application of expansive laxatives can lead to intestinal blockage; softeners are surfactants, long-term application of toxic reactions to the liver.
5, lubricants such as liquid paraffin, long-term use can prevent the absorption of fat-soluble vitamins and calcium, phosphorus, excess can lead to overflow and anal irritation, leakage from the anus will cause anal scratching.