1, what are the principles of treatment of constipation?
(1) symptomatic treatment: constipation must be targeted treatment, to identify the cause, the use of light laxatives, such as open plug, glycerin suppositories and other drugs as appropriate, but do not abuse. If necessary, you can wear a finger sleeve to reach the anus to pull out the stool, or other symptomatic treatment, such as Chinese herbal medicine.
(2) dietary principles: constipation patients should also pay attention to the therapeutic principles of diet, in general, patients should be encouraged to eat more, and food should not be too fine less dregs, it is desirable to eat more vegetables and fruits, drink more water, so that patients understand the physiology of defecation, the application of biofeedback therapy, to establish a good defecation reflex, to develop the habit of daily bowel movements on time.
(3) eliminate the causes: constipation treatment must eliminate the causes, experts pointed out: only to remove these causes, the symptoms of constipation can disappear, otherwise constipation is difficult to relieve. Therefore, whether organic constipation or functional constipation, should try to determine the cause of the basis for targeted treatment.
2.What are the treatment methods for constipation?
Commonly used treatment methods for constipation include: general treatment, drug therapy, device assistance, biofeedback therapy, cognitive therapy, acupuncture therapy, umbilical cord method, food therapy, body therapy, abdominal massage method, surgical treatment, etc.
3.What are the drug treatment methods for constipation?
(1) volumetric laxatives: mainly include soluble fiber (pectin, plantain, oat bran, etc.) and insoluble fiber (plant fiber, lignin, etc.). Volumetric laxatives have a slow onset of action with few side effects and are safe, so they are more effective for constipation in pregnancy or mild constipation, but are not suitable for rapid laxative treatment of temporary constipation.
(2) lubricating laxatives: can lubricate the intestinal wall, soften the stool, so that the stool can be easily discharged, easy to use, such as cork, mineral oil or liquid paraffin.
(3) salt laxatives: such as magnesium sulfate, magnesium milk, these drugs can cause serious adverse reactions, clinical caution should be used.
(4) osmotic laxatives: commonly used drugs such as lactulose, sorbitol. Suitable for blocked feces or as a temporary treatment measure for chronic constipation, is a better choice for constipation patients with poor efficacy of volumetric light laxatives.
(5) stimulant laxatives: including anthraquinone-containing botanical laxatives (rhubarb, senna, aloe), phenolphthalein, castor oil, diethylstilbestrol, etc.. Stimulant laxatives should be used only when volumetric laxatives and salt laxatives are ineffective, and some are stronger and not suitable for long-term use. Long-term application of anthraquinone laxatives can cause colonic black stool disease or laxative colon, causing atrophy of smooth muscle and damage to the intestinal intermuscular plexus, but aggravate constipation, reversible after discontinuation of the drug.
(6) prokinetic agents: mosapride, etopride has a pro-gastrointestinal motility, prolocabri can selectively act on the colon, can be selected according to the situation.
4, what are the side effects of drug treatment of constipation?
(1) volumetric laxatives: these drugs are slow-acting, and large doses are likely to cause abdominal distension, abdominal pain, and should be used with caution for patients with colonic weakness.
(2) Irritant laxatives: anthraquinones can cause colonic melanosis and should be used with caution.
(3) osmotic laxatives: used for the treatment of mild and moderate constipation is more effective. Lactulose, sorbitol, etc. can be decomposed in the intestinal cavity to produce lactic acid and acetic acid, lowering the pH of the colon, stimulating the colonic mucosa, and promoting intestinal peristalsis, with the main adverse effect of intestinal flatulence.
(4) lubricating laxatives: long-term application can interfere with the absorption of fat-soluble vitamins, with gastroesophageal reflux, the elderly and frail, long-term bedridden people should be cautious with such drugs to avoid causing lipid aspiration pneumonia.
(5) pro-intestinal dynamics drugs: side effects are headache, nausea and diarrhea.
5.What should I pay attention to when using laxatives?
The long-term use of any laxative will not only produce dependence, but also cause damage to the mucosa of the intestinal wall and the nerves of the intestinal wall. Therefore, on the basis of reducing the use of laxatives as much as possible, the symptoms of constipation should be improved from the level of lifestyle and psychological relief.
6.What are the advantages of navel therapy for constipation?
(1) Easy to operate: Chinese medicine navel therapy can be based on the needs of different diseases, take a quantitative amount of fresh medicine pounded, or take dry medicine grinded into fine powder with water or medicine juice, wine, ginger juice, oil, etc. fully mixed, after the umbilicus is clean, the adjusted medicine will be directly applied to the umbilicus, plus adhesive tape or ointment to be fixed. Dry medicine (crushed) can also be fried and put into a thin cloth bag and then fixed directly on the umbilicus, which is a simple and easy method.
(2) Safety of use: internal use or injection of drugs may sometimes cause negative effects due to toxic side effects of drugs or allergies to drugs that are difficult to eliminate in time, and may even lead to adverse consequences. However, it is easy to observe the patient’s adaptability and feelings at any time, so as to decide whether to continue the treatment or withdraw it. As long as the evidence is accurate, it generally does not cause damage to the body, and is easy for patients and family members to accept and master, safe and reliable.
(3) Wide range of indications: Clinical practice and medical literature show that navel therapy is useful for gynecological diseases such as menstrual disorders, dysmenorrhea, postpartum urinary retention, etc. It has unique therapeutic and auxiliary effects on pediatric diseases such as noma and enuresis, cardiovascular diseases such as hypertension, respiratory diseases, digestive system diseases and neurological diseases. Especially for patients who are senile, infantile, or suffering from acute illnesses such as “those who refuse to take medicine and cannot take medicine”, its therapeutic effects are particularly prominent and can make up for the shortcomings of internal treatment.
7.What are the precautions for the treatment of constipation with umbilical cord therapy?
(1) the use of the umbilical cord therapy must follow the principle of identification and treatment first, then the use of drugs. In the use of the umbilical cord therapy, must be based on the holistic view of traditional Chinese medicine and discriminatory treatment on the basis of the four diagnoses, combined with yin and yang, table and lane, cold and heat, deficiency and real eight, discriminatory treatment.
(2) The medicine should be selected as far as possible from the drugs with all the odors or be powdered and fried.
(3) The medicine should be covered with adhesive tape or ointment in a “closed” state as much as possible to avoid the “leakage” of the medicine to affect the therapeutic effect.
(4) In order to improve the therapeutic effect, appropriate local warming or heating of the drug can be adopted.
(5) Some drugs with strong skin irritation, pay attention to observation when using Chinese medicine to prevent skin blistering and ulceration, resulting in infection.
8.How does biofeedback therapy treat constipation?
Biofeedback therapy can be used for constipation patients with rectoanal and pelvic floor muscle dysfunction, and its long-term efficacy is better. Biofeedback therapy can train patients to relax the pelvic floor muscles during defecation, so that the abdominal muscles and pelvic floor muscle groups can coordinate their activities during defecation; and for patients with abnormal threshold of bowel movement, emphasis should be placed on the reconstruction of the defecation reflex and the training to adjust the perception of bowel movement. There are no specific norms for the training program, and the training is more intense but safe and effective. For patients with pelvic floor dysfunction, biofeedback therapy should be preferred over surgery.
9.Which patients with chronic constipation can be considered for surgical treatment?
Patients who require surgery for chronic constipation are in a very small minority. Only when the patient’s systemic non-surgical treatment is ineffective and the symptoms seriously affect work life, surgery can be considered, but the indications for surgery must be strictly mastered. Preoperative colonoscopy, colonic transmission test, anorectal manometry, etc. should be performed. For those with clear morphological and/or functional abnormalities in the examination results, the surgical method should be selected in a targeted manner. In short, patients with chronic constipation should choose surgical treatment carefully.
10.Do pregnant women need treatment for constipation?
Pregnant women are a high-risk group for constipation because of changes in their physiological structure. Many pregnant women cannot actively cooperate with the treatment because they are worried about the side effects of drugs. It is not known that defecation is an important way to detoxify the body, and prolonged stay of feces in the body will lead to toxin reabsorption, which directly endangers the health of the fetus and pregnant women. At present, the use of lactulose, polyethylene glycol and other drugs to treat constipation in pregnant women is safe and reliable. In addition, increasing dietary fiber, drinking more water and exercising properly are also important measures to prevent and improve constipation in pregnant women.