Poor gastrointestinal function is a common complication in diabetic patients, including difficulty in swallowing, reflux after eating, stomach discomfort and burning sensation, bloating, diarrhea and constipation after eating. More than 66% of diabetic patients have obvious abnormalities in vagus nerve function, resulting in reduced secretion of gastric juice, which causes difficulty in discharging food into the duodenum and slows down intestinal peristalsis, thus making them prone to constipation. Patients with diabetes, constipation occurs in almost half of the patients.
According to French statistics, the number of deaths related to constipation in hospitalized patients amounts to about 90,000 per year; in hospitalized patients suffering from diabetes, cardiovascular and cerebrovascular diseases, constipation occurs in almost half of them.
I. Etiology
Diabetic constipation mainly has the following causes
Dysbiosis of intestinal flora structure
The intestinal tract is the barometer of human health, once the body has any problems, the intestinal tract will be affected. Moreover, diabetic patients have to take medications every day to maintain stable blood sugar, and these medications have certain damage to the intestinal tract. Both the drugs and the disease itself will make the number of beneficial bacteria in the intestine decrease greatly and the number of harmful bacteria rise sharply, leading to dysbiosis of the intestinal flora structure and eventually triggering constipation and some other intestinal diseases.
Complications
High concentration of blood glucose has a damaging effect on the vegetative nerves, resulting in weak gastrointestinal peristalsis and difficult bowel movement. In addition, when suffering from diabetes, due to metabolic disorders, protein is in negative balance, resulting in insufficient tone of the abdominal and perineal muscles and weak bowel movements.
Second, the treatment method
Non-pharmacological treatment
Since diabetes involves medication and blood sugar, non-pharmacological treatment is generally recommended if the condition is not very serious. The main non-pharmacological therapies are exercise, functional oligosaccharides, and diet modification. Exercise and diet modification are more common. Exercise is mainly simple items such as jogging, Tai Chi, yoga and Bada Jin. The key to dietary modification is to eat more high-fiber foods and maintain a certain dietary balance.
Functional oligosaccharide is currently a more popular international means of treating diabetic constipation, in recent years, China has also begun to develop the use of the market has appeared in the Likin (isomalto-oligosaccharide) such a number of brands and products.
Functional oligosaccharides, belonging to the prebiotics, are widely used isomaltic oligosaccharides, fructose, xylose and so on. It is the growth factor of intestinal beneficial bacteria, after reaching the intestine, it can quickly add value to the beneficial bacteria in the intestine, so that the intestinal flora structure to restore the balance, so as to achieve the effect of laxative bowel movement.
Diabetic constipation patients need to eat the “sugar” functional oligosaccharides.
The “sugar” in functional oligosaccharides such as isomalto-oligosaccharide refers to a molecular structure, which is different from what we call sugar in our daily life. The sugars we eat every day, such as sucrose, are polysaccharides that can be digested and metabolized by the human body. Animals do not have the enzymatic system to hydrolyze isomaltic oligosaccharides in their intestines, so they are not digested and absorbed, but enter the large intestine directly and are used by bifidobacteria in priority.
Therefore, the consumption of isomalt oligosaccharides by diabetics does not affect blood sugar. Moreover, functional oligosaccharides such as isomalto-oligosaccharides, which do not affect blood sugar and have sweet taste and certain health functions, are becoming the preferred sweet additive for diabetics.
Third, drug treatment
Diabetic patients with constipation must pay attention to. For long-term obstinate constipation of diabetic patients, the current Western medicine treatment is more difficult, “wetting medicine” (such as magnesium sulfate, etc.) is actually intestinal secretion promoting agent, only due to the lack of intestinal fluid secretion caused by the stool hard; and lubricants (such as mineral oil) can cause fatty liver and fat dissolved vitamin malabsorption, should avoid the use of .
Medical science believes that diabetic constipation patients are mostly caused by the large intestine conduction malfunction, belong to the deficiency of constipation, mostly with diabetes patients spleen, kidney weakness is closely related to the kidney deficiency can not warm the spleen yang, spleen yang deficiency, transport and transformation failure, large intestine conduction weakness and cause constipation. Therefore, it is not advisable to use laxatives such as rhubarb, senna and fruit guide. Otherwise, constipation will be more serious after taking rhubarb diarrhea, take senna leaves are nausea and vomiting, taking fruit guide can only cure the symptoms. In addition, rhubarb, senna, fruit guide tablets and other such laxatives taken for a long time can also lead to degenerative lesions in the ganglion cells of the intestinal muscle layer.
Therefore, diabetic constipation patients should not use drugs indiscriminately to laxative, non-essential circumstances, but also need to go to the hospital to consult the relevant experts cautious medication.
Fourth, Chinese medicine treatment
Constipation is a common disease, and many people have more or less constipation. But for diabetic patients, constipation is not to be underestimated. Diabetic constipation is one of the common complications of diabetes, so how should the Chinese medicine treatment of diabetic constipation and how to cure it? The following Chinese medicine will help you to solve the problem of diabetic constipation.
First of all, we should understand that constipation in Chinese medicine is divided into two types, one is the actual constipation and one is the virtual constipation. Among them, real constipation is divided into two types: heat constipation and gas constipation. The so-called hot constipation is caused by the accumulation of heat in the stomach and intestines. For the treatment of heat constipation, patients can use rhubarb, senna leaf, triphala tablets, etc. to promote excretion; while qi constipation is caused by liver and stomach qi depression. For the treatment of Qi constipation, patients can use Mu Xiang, Citrus aurantium, betel nut, etc. to de-stuff the liver and regulate Qi; for deficiency constipation, patients are divided into Qi deficiency, body deficiency and Yang deficiency. Patients with Qi deficiency can use Astragalus, Rhizoma Atractylodis Macrocephalae, and Tonic Central Beneficial Qi Pill to laxative; while patients with Blood deficiency are best to use Angelica, Shengdi, and Ma Ren to nourish Blood and laxative; Yang deficiency can use Cinnamon, Radix et Rhizoma, and Dayun to warm Yang and laxative.
In general, constipation patients are used to using Western medicine for treatment, in fact, for diabetic constipation Chinese medicine also has a very significant curative effect. Above we have introduced how to treat diabetic constipation in Chinese medicine, but because patients have different physical conditions and conditions, their treatment methods are not the same, please consult the relevant experts when using the above methods of treatment.
Five, daily health care
1, diet therapy: drink more water, eat more fiber-rich vegetables, such as celery, loofah, etc.. Appropriate to eat some fruits and melons and “gas-producing” food, such as tofu, bamboo shoots, radish, etc., can promote intestinal peristalsis, conducive to laxative.
2, massage: you can rub the abdomen, do daily abdominal and anal exercises to improve the ability to defecate. Abdominal massage (especially for the relevant points) helps the gastrointestinal tract peristalsis, digestion and excretion. Abdominal massage should be along the large intestine in a clockwise direction, do circular massage. Massage can promote the peristalsis of the large intestine, there is a mechanical push the role of feces forward. Every day in the morning and evening before bedtime massage, each time 5 to 10 minutes. In the defecation, in addition to massage the abdomen, but also from the bottom up massage the coccyx, lumbar vertebrae on both sides, help to complete the defecation reflex process.
3, physical exercise: in addition to general whole body exercise (walking, jogging, etc.), constipation should focus on strengthening the exercise of abdominal muscle strength, such as abdominal lifting, sit-ups, etc.. Usually can also do more squatting and hip flexion and abdominal movements to promote intestinal peristalsis. Bedridden patients appropriate to increase the amount of activity, guide bed activities to promote gastrointestinal motility. Patients who can get out of bed, family members and nannies to assist in life care, and urge patients to carry out 2 to 3 times a day indoor or ward around walking and other light activities.
4.Psychological and habit adjustment should be done to develop good living habits, make good psychological adjustment, and develop good habits of regular bowel movement (1 time per day or every other day).
5, drug therapy, according to the patient’s blood glucose level to choose oral hypoglycemic drugs or insulin, and gradually make the blood glucose smoothly reach the standard, the better the blood glucose control, the better the effect of constipation treatment; application of nerve-nourishing drugs such as Micropod, Kaina, Tanglin, vitamin B1 and other drugs; gastrointestinal motility drugs such as morpholine and cisapride.
6, Chinese herbal medicine, such as Si Mo Tang, Six Flavors Anxious, Ma Ren Run, compound aloe vera, etc., also have certain efficacy.
7, the use of microecological preparations, constipation patients often lack of bifidobacteria, after supplementation, not only regulate the intestinal flora, but also can promote the smooth muscle contraction of the intestine, favorable defecation.
8, daily life to tea as a drink in addition to prevent and improve the treatment of inflammation can also regulate the balance of human mechanisms, detoxification, anti-inflammatory and antibacterial, cleanse intestinal toxicity, discharge field stool effectively relieve constipation.