fecal impaction
Introduction
Introduction The dry fecal block obstructs the rectum and can not be discharged, causing severe constipation symptoms and perineal pain, becoming a fecal impaction, a form of rectal constipation. Rectal constipation occurs mostly in the morning without defecation time, hemorrhoids, anal fissure pain and frequent enema. Rectal constipation in patients with anal fissure can exacerbate anal fissure, as stools during rectal constipation tend to be particularly hard. Rectal constipation is that the feces have already reached the rectum, but because the nerve reaction is slow, it can not cause the intention, so that the large intestine can not move, which causes difficulty in defecation.
Cause
Cause
Due to the reduced sensitivity of rectal mucosal receptors, the accumulation of feces in the sigmoid colon, such as eating too little, lack of water or lack of cellulose in food, lack of regular habits of bowel movements and affect constipation caused by bowel reflex.
1. Abuse of laxatives: Due to the frequent and unreasonable use of laxatives, the sensitivity of rectal mucosal baroreceptors is reduced or lost. Therefore, when the feces in the rectum are filled, it cannot cause defecation reflexes and cause fecal impaction.
2, anus, rectal lesions and anorectal surgery shortly after: due to perianal lesions such as anal fissure, and surgical incision pain makes the patient fear of defecation, actively suppressing defecation activity, so that the feces accumulate in the rectum for too long, causing feces Impact.
3, systemic sclerosis and dermatomyositis: lesions spread to the rectum and colon, so that the colon, rectal muscle fibrosis, tension weakened or disappeared, so that rectal reflexes weakened, fecal impaction occurred.
4, low spinal cord lesions: such as sputum 2, 3, 4 basin parasympathetic nerve damage, horsetail tumors, etc., blocking the bowel reflex arc, causing fecal impaction.
5, diabetic neuropathic constipation.
6, constipation patients with sputum enema.
7, long-term bed rest constipation.
Examine
an examination
Related inspection
Fecal smell, fecal traits, stool color, regular stool volume
The rectum is about 10 cm long, like a short, flexible tube that temporarily stores a certain amount of feces. When the amount of feces in the rectum reaches a certain level, it will cause the rectum to swell, causing irritation to the baroreceptors in the intestinal wall, causing defecation reflexes. If you often suppress the intention (defecation of bowel movements), often taking laxatives or enema catharsis, The sensitivity of the rectal mucosa to stimulation is reduced, the bowel movement is slow, the stool is deposited in the rectum for a long time, and gradually becomes a large hard block, blocking the rectum, and the pressure in the rectum is rapidly increased, which can cause strong intentions, perianal and basin. The underlying tendon, pain, bulge, and occasionally a small amount of dilute feces can leak out. At this time, the rectal examination can touch the hard fecal mass. If the fecal mass can be pushed up, soft stools can flow out from the side.
Diagnosis
Differential diagnosis
The clinical manifestations of constipation should be identified with too few stools, or poor bowel movements, laboriousness, difficulty, dry stools, and minimal constipation.
