Often psychiatric patients have constipation, but because some patients have cognitive impairment, they cannot actively talk about their condition, which aggravates their pain during diagnosis and treatment; some patients are even more psychologically burdened by constipation, which induces aggravation of psychiatric symptoms. Causes of constipation in psychiatric patients The common type of constipation in psychiatric patients is functional constipation, the cause of functional constipation is not clear, and its occurrence is related to a variety of factors, including: 1, neglect of normal bowel movements Not to develop the habit of regular bowel movements, the bowel reflex is inhibited, causing constipation over time. 2, lack of food fiber Due to some patients due to mental disorders, resistance to diet or eating partiality. Due to the lack of fiber, the volume of stool is reduced, the viscosity is increased, the movement in the intestine is slow, and the water is absorbed excessively, which leads to constipation. 3.Insufficient fluid intake Less water intake, water is mostly absorbed by the intestine, resulting in dry stool, defecation difficulties, and then constipation. 4, reduced movement, especially in patients who are bedridden or wheelchair-bound for a long time, lack of locomotor stimulation and movement to push the stool, ingestion itself can not make the stool forward. 5, environmental interference Because of work, life and other trivial matters, bad mood and bad rest and other reasons interfere with the normal defecation habits. 6, the abdominal muscles and pelvic muscle tension is not enough muscle tone, the driving force of the feces is not enough, it is difficult to push the feces out of the body. 7, abuse of laxatives Formation of drug dependence. 8, the role of antipsychotic drugs Most of the clinically used antipsychotic drug therapy have anticholinergic effects, producing anticholinergic side effects. The use of antipsychotic drugs will reduce glandular secretion and cause dry mouth and constipation. The sedative effect of antipsychotics also slows down the bowel movement of patients. Some patients experience drowsiness and weakness due to the excessive sedative effects of antipsychotic medications, which makes constipation more likely to occur. Antipsychotic drugs such as chlorpromazine, thioridazine, clozapine, olanzapine, and vincristine; and antidepressants such as amitriptyline, doxepin, promethazine, chlorpromazine, fluoxetine, sertraline, and paroxetine all have these side effects. Self-regulation of constipation in psychiatric patients 1, dietary regulation often eat foods rich in dietary fiber, such as whole grain (coarse grains) food, potatoes, green vegetables, celery, bamboo shoots, cabbage, cucumber, loofah, white radish, apple, banana, pear, etc.. Several of these foods can be appropriately selected for daily consumption to stimulate intestinal peristalsis. Nuts can be laxative and can be consumed by choice. Drink at least 8-10 cups of warm boiled water that is naturally cooled after boiling on the same day, or drink cassia seed tea or green tea, and especially make sure to drink one cup of plain water each day before going to bed and after waking up in the morning. It can wash the stomach and intestines and soften the stool. In addition, the morning and three meals after the intestinal peristalsis is often active, easy to start defecation, you can choose as a defecation time. 2, abdominal massage, gymnastics every morning and evening and after the nap with two folded hands to knead the abdomen, the navel as the center, clockwise knead 100 times, sitting, lying, standing can do. Can promote abdominal blood circulation, promote intestinal peristalsis, help digestion, through the intestines and stomach, and promote smooth stool. This is also related to the direction of the colon, the operation of the colon is from the lower right abdomen, up to the transverse colon, and then through the transverse colon to the left side, through the descending colon, and finally to the sigmoid colon, in order to be discharged from the body. In addition, do “abdominal and anal action” daily, 60 times each morning and evening. 3, moderate exercise every morning and evening jogging, walking, promote gastrointestinal peristalsis. In addition, insist on doing abdominal whistling in the morning and evening, for 15 minutes, so that the abdomen, waist and back with a feeling of heat. With the undulating movement of the abdominal muscles, the stomach and intestinal activity increased, digestive function has also been enhanced, the excretion of dregs more thoroughly. 4, emotional regulation nervousness, anxiety and other bad emotions can aggravate constipation, while a calm, relaxed state of mind will reduce constipation or promote the recovery of constipation. 5, to develop good bowel habits regular defecation, without delay. After waking up and after meals, the action potential activity of the colon is enhanced, which pushes the stool to the distal end of the colon, so it is the easiest time to defecate in the morning and after meals. You need to defecate promptly when you have the urge to defecate. Medication for constipation in psychiatric patients Patients should go to a specialized hospital and take the following medications under the guidance of a doctor. 1.Volumetric laxatives mainly include soluble fiber (pectin, plantain, oat bran, etc.) and insoluble fiber (plant fiber, lignin, etc.). Volumetric laxatives have slow onset of action and small side effects, safe, so it has a better effect on pregnancy constipation or mild constipation, but not suitable as a rapid laxative treatment of temporary constipation. 2, lubricating laxatives can lubricate the intestinal wall, soften the stool, so that the stool is easy to discharge, easy to use, such as cork, mineral oil or liquid paraffin. The stool for a long time, the water is absorbed, the formation of thick and hard manic stool, especially the first half of the stool, it is hard as stone, it must be softened. You can soak it with a corked lotion. Note that the soaking time needs to be at least ten minutes, and do not solve the stool immediately after using the cork mixture, as this is ineffective. It is not recommended to force the stool by yourself. Dry, hard stool is usually much thicker in diameter than the anus. Violent defecation can cause anal fissures and other situations, if there is anal pain after the stool, blood in the stool and other symptoms, please promptly to the professional anorectal examination and treatment. 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 are lactulose, sorbitol, polyethylene glycol 4000, etc.. Applicable to fecal block embedded or as a temporary treatment measures 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, Frangipani, senna, aloe), phenolphthalein, castor oil, diethylstilbestrol, etc.. Stimulant laxatives should be used only when volumetric laxatives and salt laxatives are ineffective, some of them 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. 6, pro-dynamic agents Mosapride, Itopride has a pro-gastrointestinal dynamics, Pulucapride can selectively act on the colon, can be selected according to the situation. 7, proprietary Chinese medicine, such as Cistanches laxative oral liquid, maren pill, maren soft capsule, lungi pill, etc. 8.Saline If the stool is hard and stagnant in the rectum near the anal opening or if the patient is old and frail and has poor defecation power or lack of it, the method of colon hydrotherapy or cleansing enema can be used. Due to the complex and special condition of such patients, the side effects of clinically applied therapeutic drugs are too great, and patients often have constipation, if not treated in a timely manner, the continued development of fecal stones can be formed, and in serious cases, intestinal obstruction and life-threatening, so families and related caregivers must be careful and conscientious, when patients have constipation and other symptoms to professional hospitals for timely consultation.