Clinical manifestations and causes of constipation
What is constipation?
Among the general public, some say that difficulty in defecation is constipation, some say that dry and hard stools are constipation, and some say that having a bowel movement once every 3-4 days or even at longer intervals is constipation. Indeed, these are all manifestations of constipation, but if any one of these manifestations is defined as constipation is not comprehensive. According to medical science, constipation is a group of symptoms that can be caused by a variety of diseases, and generally refers to a small number of bowel movements, difficult discharge or both, accompanied by discomfort such as abdominal pain, bloating, nausea, bitterness in the mouth, anal pain, a feeling of incomplete defecation, blood in the stool, and irritability.
Clinical manifestations of constipation
From the definition of constipation, we can realize that constipation itself is not an independent disease, but a group of symptoms that can be manifested by a variety of diseases in the digestive tract. Its clinical manifestations can be recognized from the following three aspects.
First, the corresponding manifestations of the primary disease leading to constipation
For example, colorectal cancer may have mucus and blood stool and lumps; anal fissure may have painful defecation and fresh blood stool; hypothyroidism may have chills and mucus edema, etc.
The performance of defecation disorder
1.Fewer natural stools, less than three times a week, less stool volume, longer intervals between natural bowel movements, and can gradually worsen.
2.Difficulty in defecation
Can be divided into two cases. One is dry and hard stool, such as chestnut, difficult to pass. Another situation is that the stool is not dry and hard, but also difficult to discharge. Some patients feel a sense of obstruction above the anus, and the greater the force of defecation, the stronger the obstruction, forcing patients to exert excessive force, and even loud moaning, very painful. Some female patients have the feeling of fecal foreshortening and feel that the fecal mass is not descending towards the anus but towards the vagina; experienced patients can easily discharge the fecal mass by sticking their fingers into the vagina and applying pressure to the back wall. Some patients feel fullness in the rectum, pain in the coccyx, and incomplete defecation; using a finger, paper roll, or soap bar inserted into the anus can make defecation easier. Among these patients, most of them have bowel movement, and the bowel movement is frequent, and the time of each bowel movement is prolonged, up to 2 hours, which is extremely painful for patients.
3.Companying symptoms
In addition to the aforementioned characteristic manifestations of the primary disease, for those patients who are not found to have obvious abnormalities by routine examination, common concomitant symptoms include abdominal distension, abdominal pain, thirst, nausea, and perineal distension. Most patients have mood irritability, and some patients also have bitter mouth, headache, and skin rash. A few patients are nervous, individual even have suicidal tendencies.
Third, the etiology of constipation
In clinical practice, many patients will ask the question: how does constipation form? From the definition of constipation, we can easily see that there are many causes of constipation, specifically including intestinal lesions, extra-intestinal lesions and poor lifestyle habits in three categories.
First, intestinal lesions: including anal, rectal, colon organic or functional disorders.
1, colon obstruction: common diseases such as tumor, colon torsion, inflammation, endometriosis, anastomotic stenosis, intestinal overlap, etc.
2, rectal and anal canal outlet obstruction: common diseases such as rectal and anal canal stenosis, anal fissure, hemorrhoids, rectal prolapse, endorectal overlap, rectal prolapse, pelvic floor spasm syndrome, perineal descent syndrome, etc.
3. Visceral nerve and muscle lesions: common diseases such as congenital megacolon, colonic weakness, acute and chronic pseudo-intestinal obstruction, irritable bowel syndrome, etc.
IV. Extra-intestinal lesions
1, neurological: central nervous system lesions (brain tumor, Parkinson’s disease), sacral nerve or spinal cord injury, neurological deficits, spinal cord tumors, etc.
2, psychiatric: such as depression, psychosis, anorexia nervosa, etc.
3, endocrine and metabolic: hypothyroidism, pregnancy, diabetes, dehydration, uremia, lead poisoning, hypopituitarism, etc.
4, medical source: drug, brake, laxative colon, etc.
V. Poor diet and habits
Less crude fiber in food, drinking less water, lack of exercise, environmental changes (such as travel), neglect of constipation can lead to the occurrence of constipation.
Among the above causes, it is worth noting that
1, in daily life: emotional discomfort, mood, anger, sadness and worry; not to develop a regular bowel movement, the habit of living on time; addicted to fine rice and noodles, spicy barbecue and other hot and dry diet, or eat too little, good and bad work, long-term lack of labor or bedridden, etc., are common causes of constipation, we should try to avoid.
2, due to disease fear row: patients suffering from hemorrhoids, anal fissures and other disorders due to severe pain, bleeding, prolapse and other painful symptoms, often fear of defecation, intentionally prolong the interval between defecation, so that the feces in the rectum for too long, the water is fully absorbed, the formation of fecal stones blocking the intestines leading to constipation.
3, the danger of laxatives: constipated patients, often for the fast bowel movement, often self-serving rhubarb, senna, petunia and other laxatives. Some doctors for coping with laxative, also often asked patients to take three yellow tablets, niuhuang detoxification pills, intestinal clearing tea and so on. Over time, do not take laxatives will not be able to defecate on their own, resulting in more diarrhea more secret, become laxative-dependent constipation.
As can be seen, if constipation, patients should not blindly deal with their own, should be timely to the regular large hospitals of the anorectal specialist for systematic examination, to be clear after the cause of targeted treatment, symptomatic treatment, in order to effectively treat constipation.