Chronic constipation Chronic constipation is a long period of recurrent constipation, the onset of which can be from acute constipation that does not heal for a long time, or it can be chronic constipation at the onset, the latter is more common in constipation caused by chronic diseases. Constipation is a condition of constipation, prolonged defecation time or the desire to defecate but difficult to smooth, constipation can be temporary, but also long-term, usually long-term constipation we also call chronic constipation. The Rome II diagnostic criteria for chronic functional constipation, which were developed again at the World Congress of Gastroenterology held in Rome in 1999, set the diagnostic criteria for chronic functional constipation as follows: 2 or more of the following symptoms occurring continuously or intermittently for at least 3 months in the past year: (1) straining to defecate less than 1/4 of the time; (2) (2) dry stool less than 1/4 of the time; (3) incomplete bowel movement less than 1/4 of the time; (4) anal obstruction or anorectal obstruction during bowel movement less than 1/4 of the time; (5) manual assistance for bowel movement less than 1/4 of the time; (6) bowel movement less than 3 times a week less than 1/4 of the time. The absence of loose stools does not meet the diagnostic criteria for irritable bowel syndrome; constipation due to intestinal or systemic organic causes as well as pharmacological factors should be excluded. Etiology of chronic constipation Chronic constipation has functional and organic causes. Organic causes can be caused by gastrointestinal diseases, systemic diseases involving the digestive tract such as diabetes mellitus, scleroderma, neurological diseases, etc. Many drugs can cause constipation, as follows: organic lesions of the intestinal tract such as tumors, inflammation or other causes of intestinal lumen narrowing or obstruction. 1. rectal and anal lesions: endorectal prolapse, hemorrhoid disease, anterior rectal bulge, puborectal hypertrophy, puborectal separation, pelvic floor disease, etc. 2. Endocrine or metabolic diseases: such as diabetic enteropathy, hypothyroidism, parathyroid disease, etc. 3. Neurological disorders: such as central brain disorders, stroke, multiple sclerosis, spinal cord injury and peripheral neuropathy 4. Intestinal smooth muscle or neuronal lesions 5. Colonic neuromuscular lesions: pseudo-intestinal obstruction, congenital megacolon, megarectum, etc. 6. mental and psychological disorders 7. pharmacological factors: aluminum antacids, iron, opioids, antidepressants, anti-Parkinson’s disease drugs, calcium channel antagonists, diuretics, and antihistamines, etc. 8, other: exercise less, special occupation, or after having received abdominal or pelvic surgery, patients taking special drugs. Chronic constipation types Chronic constipation types: slow transmission type, outlet obstruction type and mixed type The constipation type of IBS is a type of constipation related to abdominal pain or bloating, at the same time, may also have the characteristics of the following types. 1, slow transit constipation (STC) has the following manifestations: (1), there is often a reduction in the number of bowel movements, less bowel movements, hard stool, and therefore difficult to defecate. (2).No stool or hard stool on anorectal examination, while the contraction and force of the external anal sphincter function normally. (3).Prolonged passage time of the whole stomach and intestine or colon. (4), lack of evidence of outlet obstruction type constipation, such as normal balloon expulsion test, anorectal manometry shows normal. 2, outlet obstructive constipation (OOC) may have the following manifestations: (1), straining to defecate, incomplete or falling sensation, small volume of defecation, bowel movement or lack of bowel movement. (2) There is a lot of mud-like stool in the rectum on anorectal examination, and the external anal sphincter is paradoxically contracted during forceful defecation. (3).The whole gastrointestinal or colonic passage time shows normal, and most of the markers can be retained in the rectum. (4), anorectal manometry shows paradoxical contraction of the external anal sphincter during forceful evacuation, etc. or abnormal sensory threshold of the rectal wall. 3, mixed constipation: with the characteristics of 1 and 2 above. Chronic constipation according to the onset of site classification Chronic constipation etiology is more complex, according to the onset of site classification, can be divided into two kinds: 1. Constipation caused by mechanical obstruction within and outside the colon is called mechanical constipation. Constipation caused by the weakening or loss of peristaltic function of the colon is called incompetent constipation. Constipation caused by spasm of intestinal smooth muscle is called spastic constipation. 2. Rectal constipation. Due to the weakened sensitivity of rectal mucosal receptors resulting in the accumulation of fecal masses in the rectum. It is seen in rectal cancer, perianal disease, etc. Habitual constipation is mostly seen in middle-aged and elderly and menstruating women. Chronic constipation causes 1, less exercise: the elderly due to the amount of activity, abdominal muscle weakness, slow gastrointestinal peristalsis, food and residue is not easy to push down, prone to constipation. 2, poor mental fitness: mental tension, depression, most of the elderly have constipation symptoms, which is due to neurological disorders. Some chronic diseases, such as low thyroid function, psychological disorders, etc. can appear constipation symptoms. 3, drug factors: many elderly people suffering from cardiovascular disease, the need for long-term drug treatment. And some anti-hypertensive drugs, diuretics, etc. can cause constipation. 4, lack of water in the body: the elderly thirst sensory function decreases, and do not feel thirsty when there is a lack of water in the body, which makes the elderly intestinal water reduced, resulting in dry stools. 5, dietary factors: lack of foods with high fiber content in the diet, especially lack of coarse grains and fruits, resulting in reduced water and dysbiosis in the large intestine, causing constipation. Clinical manifestations Chronic constipation mostly has no obvious symptoms, but those with hypersensitivity may complain of gastrointestinal symptoms such as loss of appetite, bitter mouth, bloating, belching, episodic lower abdominal pain, exhaustion, etc. It may also be accompanied by dizziness, headache, easy fatigue and other neurosis symptoms. The occurrence of symptoms may be related to intestinal motility dysfunction or to psychological factors. Due to the dry and hard stool, or sheep stool, patients may have discomfort such as spasmodic pain and falling sensation in the lower abdomen. Sometimes a spastic sigmoid colon can be palpated in the left lower abdomen. Chronic constipation can still be divided into organic constipation and functional constipation, which occurs in the elderly and the frail and sickly people. Chronic constipation because of its constipation occurs for a long time, the human body is more harmful, so patients suffering from chronic constipation must pay attention to the treatment of it. Chronic constipation treatment measures 1, the treatment of the original disease: the original disease has been identified, after a clear diagnosis, the use of appropriate measures for active treatment. Such as anal fissure can be local anesthesia anal expansion or internal sphincter lateral excision treatment; colon tumors are radical or palliative resection; such as drug-induced constipation, the drug should be discontinued or change to other drugs that do not cause constipation; psychiatric, endocrine metabolic disease caused by constipation should be treated accordingly to eliminate the impact of the original disease on intestinal function as soon as possible. 2, general treatment: in the primary disease is difficult to correct or not detected for a while with obvious primary factors, the use of general measures for most patients with constipation is beneficial. 3, drug therapy: can be used for constipation treatment of many drugs, but most are not suitable for patients with chronic constipation, and not suitable for long-term application. At present, the phenomenon of laxative abuse is more common, resulting in a small number of medical constipation, should be carefully selected clinically. 4, enema: the main indications are preoperative intestinal preparation, fecal impaction, acute constipation. Warm saline is more suitable, because of its small intestinal stimulation. Soap and water should be avoided because it is too irritating to the colonic mucosa. In addition, frequent enemas are dependent, should be noted. 5, surgical treatment: the indications for surgical treatment are mainly constipation caused by organic or functional lesions of the colon, rectum and anal canal. Chronic constipation diet chronic constipation patients should eat more fruits, especially in the season of vegetable deficiency, eat 1 to 2 fruits a day, such as oranges, apples, pears, peaches, watermelon, etc., both to increase the variety of vitamins, but also conducive to keep the stool open; some people recommend drinking 1 to 2 cups of honey water every day, or sesame seeds fried and crushed, mixed in food, for the prevention of constipation is beneficial. Patients with chronic constipation should pay attention to the coarse and fine collocation, choose some coarse grains, such as cornmeal, millet, buckwheat noodles, sweet potatoes, red beans, etc., in which the food has more formed parts, is conducive to stimulate the intestinal physiological peristalsis, reduce constipation. Side food selection of some vegetables containing more fiber, such as radish, leek, celery, cabbage, rape, etc., so that the increase in food residues through the intestinal tract, can increase the number of stools. If you add some vegetable oil in the food, such as soybean oil, peanut oil, sesame oil, etc., can also have laxative function; diet to increase some soup, usually pay attention to drink more water, if necessary, drink 1 cup of light salt water every morning, help keep the water in the intestines, is conducive to softening stool, can reduce constipation. The dangers of chronic constipation Constipation is not a major disease, but it is very painful, and can lead to a number of complications, the accumulation of stool in the intestines, and constantly produce a variety of toxic gases, toxins, resulting in the deterioration of the intestinal environment, gastrointestinal dysfunction, endocrine disorders, metabolic disorders, poor appetite and sleep, mental tension. The persistent stool compresses the intestinal wall, injures the intestinal mucosa, slows down intestinal peristalsis, leads to habitual constipation and stubborn constipation, the foul gas produced by the persistent stool leads to bad breath and foul farts, the 22 toxins produced by the persistent stool are repeatedly absorbed by the intestines and reach all parts of the body through blood circulation, leading to dull complexion, rough skin, dilated pores, brown spots, acne, fine wrinkles, obesity, weakness, irritability, and the toxins in the persistent stool enter the blood It leads to hypertension, heart disease, hemiplegia and dementia, and also aggravates cardiovascular diseases in middle-aged and elderly people. For hypertensive and coronary heart patients, constipation is very dangerous, these patients are often sudden cerebrovascular accidents during defecation, coronary heart disease aggravated, and even death. For young people, constipation can lead to endocrine disorders, producing temper tantrums and facial acne sores. In addition, constipation can also cause high fever and cough. For these diseases, treatment by laxative can be miraculously effective. Constipation has a greater impact on women and may cause menstrual disorders and malposition of the uterus. This is due to overfilling of the rectum with feces, where the cervix is pushed forward while the body of the uterus is tilted backward. If the posterior tilt of the uterus occurs repeatedly over a long period of time, the veins in the broad ligament become compressed and do not flow freely. As a result, the uterine wall also becomes congested and loses elasticity, which, in turn, keeps the uterus in a posteriorly inclined position for a long time, resulting in sacral pain, lumbago, menstrual disorders, and anorectal distention during menstruation. What is chronic constipation and what are the dangers Constipation is a common condition caused by a variety of etiologies. Patients often have dry stools, difficulty in defecation or a sense of incompleteness, and a significant decrease in the number of complete evacuation of stools when laxative medication is not used. Data on constipation surveys vary from country to country. The prevalence of constipation in the U.S. population ranges from 2% to 28%, and a survey of older people over 60 years of age in Beijing, Tianjin and Xi’an in China showed that the rate of chronic constipation among older people over 60 years of age in China was as high as 15%-20%. A randomized, stratified and graded survey of adults aged 18-70 in Beijing showed that the prevalence of chronic constipation was 6.07%, with women being more than four times that of men, and that mental factors were one of the high-risk factors. The danger of constipation: With the change of diet structure and the influence of psychological and social factors, constipation has seriously affected the quality of life of modern people; and has an important role in the occurrence of colon cancer, hepatic encephalopathy, breast disease, progeria and other diseases; in acute myocardial infarction, cerebrovascular accidents, constipation can lead to life accidents; some constipation and anorectal diseases, such as hemorrhoids, anal fissures, etc. are closely related Therefore, the only way to avoid the hazards of constipation is to have a good understanding of the disease. Therefore, to avoid the hazards of constipation only early prevention and reasonable treatment of constipation, will greatly reduce the serious consequences of constipation and social burden. Chronic constipation affects male sexual function Studies have shown that there is a link between long-term constipation and sexual life, and if men suffer from constipation, it will lead to a series of symptoms of sexual dysfunction. To explore the root cause of constipation affects the life of couples, but also from the principle of the human bowel reflex to talk about. Stimulate the human bowel movements of the defecation center is located in the sacral medulla, people with chronic constipation symptoms, this set of central reflex process is not smooth, not only the rectum long-term involvement, resulting in anal pressure instability, perianal contraction is too tight, but also cause chronic stimulation of the pelvic muscle groups around the rectum, anal raphe, perineal deep transverse muscle, urethral vaginal structure muscle, ball cavernosus muscle can be spasmodic contraction state. These muscle groups are precisely the same as the normal play of penile erection and ejaculation has a very close relationship. In addition, chronic constipation is a “catalyst” for the formation of anal hemorrhoids, which can lead to perianal pain, bleeding, and infection, causing great psychological stress to the patient. Anal hemorrhoids and chronic constipation are often the cause and effect of each other, easily forming a vicious circle. Experts remind that when sexual dysfunction occurs, you must pay attention to whether you have constipation, do not take chronic constipation lightly. In addition, some people suffering from constipation, often buy their own pharmacy laxatives to take, which is highly undesirable. Because if improper medication, not only can induce colonic melanosis and neurogenic pseudo-obstruction, but also will produce serious drug dependence. Chronic constipation treatment methods of Chinese medicine 2. peony Gan soup with flavor to cure constipation: take 30 grams of raw peony, 20 grams of raw licorice, 15 grams of Citrus aurantium, add 2 bowls of water decoction into a large bowl, 1 dose per day, divided into 2 doses. This formula treats 9 5 cases of constipation due to various causes, with satisfactory results. This method is particularly suitable for the elderly, long-ill adult patients with constipation, but pregnant women should be used with caution. 3. forsythia treatment constipation: take forsythia 15 ~ 30 grams, decoction when tea drink, 1 dose daily. Children can be mixed with white sugar or rock sugar (no sugar effect is better) to take. Continue to take 1 to 2 weeks, you can stop taking. This formula is particularly suitable for post-surgery constipation, women (expectant, menstrual, postpartum) constipation, post-traumatic injury (cranial injury, lumbar fracture, paraplegia) constipation, hypertension constipation, habitual constipation, senile constipation, cerebrovascular disease constipation and cancer constipation, etc. 4. psyllium treatment constipation: daily take psyllium 30 grams, add water decoction into 150 ml, 3 times a day, before meals, 1 week for a course of treatment. General treatment 1 to 4 courses of treatment can be cured. Stop taking other drugs during the course of treatment. This formula can not only treat constipation, but also have a lowering effect on blood pressure, especially for hypertension and constipation patients. In addition, with psyllium as the main treatment of diabetic constipation patients, have obvious recent and long-term effects. 5. fat sea treatment constipation: take fat sea 5, put in a tea cup or bowl, with about 150 ml of boiling water brewed 15 minutes, to be large, a small number of times frequently drink and serve, and will be large fat sea also slowly eat, fat sea kernel do not eat, generally drink and serve 1 day stool can be smooth. 6 . Atractylodes macrocephala for constipation: take the right amount of raw Atractylodes macrocephala, crushed into a very fine powder, each time you take Atractylodes macrocephala 10 grams, 3 times a day. This method is very effective on the false constipation, generally 3 to 5 days with medicine, stool can be restored to normal, stool can be stopped after normal, after 2 to 3 days a week to take medicine, you can keep normal stool for a long time. Chronic constipation diet adjustment program (1) food should not be too fine, not to mention partial diet, increase the fiber content of the diet, such as grains and cereals, vegetables (radish, leek, raw garlic, etc.), fruits (apples, dates, bananas, pears, kiwi, watermelon, oranges, grapefruit, dates, mulberries and other fruits rich in dietary fiber). (2) Take in enough water. Drink 1-2 cups of light salt water or boiled water or honey water every morning on an empty stomach can prevent constipation. (3) Diet intake of appropriate amounts of vegetable fats, such as sesame oil, soybean oil, etc., the consumption of hard fruits containing more vegetable oils, such as walnuts, sesame seeds, etc. (4) Appropriate consumption of foods that help laxative, such as honey, yogurt, etc. (5) can often eat some of the role of the prevention and control of constipation porridge such as sesame porridge, walnut porridge, spinach porridge, sweet potato porridge, etc. (6) eat less strongly stimulating heat food, such as chili, curry and other condiments, avoid drinking alcohol or strong tea. Chronic constipation how to do long-term chronic constipation: find a specialist, analyze the causes, individualized solutions. Laxative dependence: gradually change stimulant laxatives to osmotic or volumetric laxatives to restore intestinal dynamics; diabetes: control blood sugar and add dietary fiber to kill two birds with one stone; fine diet: dietary fiber; intestinal environment disorders: dietary fiber and beneficial bacteria supplementation; psychological disorders: psychological guidance and adjustment There are still a considerable number of patients with long-term persistent constipation need to find a specialist to discover the lesion through special examination. The doctor will take a detailed medical history; fecal imaging; colon transfer test; colonography; anorectal pressure measurement; pelvic floor electromyography, etc. Chronic constipation is a common disease in the elderly. Due to the poor absorption ability of the elderly, the effect of medication is obvious, but if we can pay attention to the reasonable arrangement of diet for patients with chronic constipation, sometimes the effect is better than medication. As often eat rich powder, fine rice and other fine food people often have constipation, therefore, the choice of food, to ensure that the premise is easy to digest, pay attention to the coarse and fine collocation, choose some coarse grains, such as corn flour, millet, buckwheat noodles, sweet potatoes, red beans, etc., in which the food has more formed parts, is conducive to stimulate the intestinal physiological peristalsis, reduce constipation. Side food selection of some vegetables containing more fiber, such as radish, leek, celery, cabbage, rape, etc., so that the increase in food residues through the intestinal tract, can increase the number of stools. If you add some vegetable oil in the food, such as soybean oil, peanut oil, sesame oil, etc., can also have laxative function; diet to increase some soup, usually pay attention to drink more water, if necessary, drink a cup of light salt water every morning, helps to keep the water in the intestine, is conducive to softening stool, can reduce constipation. Patients with chronic constipation should eat more fruit, especially in the season of vegetable shortage, eat fruit every day, such as oranges, apples, pears, peaches, watermelon, etc., not only to increase a variety of vitamins, but also to help keep the stool smooth; some people recommend drinking honey water every day, or sesame seeds fried and crushed, mixed in the food, for the prevention of constipation is beneficial. What are the common causes of chronic constipation Chronic constipation is a long period of recurrent constipation, its onset can be from acute constipation for a long time without transformation, but also at the onset of chronic constipation, the latter is more common in constipation caused by chronic diseases. Chronic constipation has the following common causes: 1, less exercise: the elderly due to low activity, abdominal muscle weakness, slow gastrointestinal peristalsis, food and residues are not easy to push down, prone to constipation. 2, poor mental fitness: mental tension, depression, most of the elderly have constipation symptoms, which is due to neurological disorders. Some chronic diseases, such as low thyroid function, psychological disorders, etc. can appear constipation symptoms. 3, drug factors: many elderly people suffering from cardiovascular disease, the need for long-term drug treatment. And some anti-hypertensive drugs, diuretics, etc. can cause constipation. 4, lack of water in the body: the elderly thirst sensory function decreases, and do not feel thirsty when there is a lack of water in the body, which makes the elderly intestinal water reduced, resulting in dry stools. 5, dietary factors: the lack of foods with high fiber content in the diet, especially the lack of coarse grains and fruits, resulting in reduced water and dysbiosis in the large intestine, causing constipation. What are the characteristics of chronic constipation Chronic constipation can be from acute constipation for a long time, but also in the onset of chronic constipation, the latter is more common in constipation caused by chronic diseases. Chronic constipation can be caused by gastrointestinal diseases, systemic diseases involving the digestive tract such as diabetes, scleroderma, neurological diseases, many drugs can also cause constipation, common causes are lack of bowel power, such as old age and frailty, obesity or significant wasting, multiple pregnancies, maternity caused by the abdominal muscle, intestinal smooth muscle, anal muscle weakness; mental nerve too nervous fatigue, colon dysfunction, can cause constipation The patient with chronic constipation has the following characteristics Patients with chronic constipation have the following characteristics: the patient fails to defecate after 40 hours of eating food residues, or often relies on drugs or enemas, and the voluntary defecation reflex is weakened. Chronic constipation can still be divided into organic constipation and functional constipation, which is more common in the elderly and the frail and sick. Chronic constipation is more harmful to the human body because of its longer duration of constipation, so patients suffering from chronic constipation must pay attention to its treatment.