intractable constipation
Introduction
Introduction Intractable constipation is a type of disease that gradually causes difficulty in defecation at different ages due to congenital knot and rectal anatomical variation. For intractable constipation, it is advisable to clear the intestines before defecation. That is to use the saline enema to clean the intestine, 2 / d, a total of 3 / d. Check the abdomen after clearing the intestines, and take a flat piece of the abdomen to confirm that there is no fecal impaction in the intestine. After the bowel is cleaned, it can be given paraffin oil, 5-15 ml/d, or lactulose 15-30 ml/d, so that the stool reaches at least 1/d. At the same time, patients are encouraged to resolve their stool after premature delivery. If they are still not defecation, they can also encourage the patient to re-examine after dinner, so that the patient gradually resumes normal bowel habits. Once the postprandial defecation occurs regularly and reaches 2-3 months or more, liquid paraffin or lactulose can be gradually stopped. In the above process, if there is no solution for 2 to 3/d, the intestines should still be cleaned to avoid recurrence of fecal impaction. The literature reports that this method of treating habitual constipation through the method of clearing the intestines, taking laxatives and training bowel habits can achieve a success rate of 70%-80%, but many will relapse.
Cause
Cause
The cause of intractable constipation:
1. Intestinal peristalsis is slow: the frequency of intestinal peristalsis in the elderly is reduced, the water in the intestine is relatively reduced, and the dry stool causes constipation. In response to this situation, it is recommended that the elderly do some abdominal massage before going to bed every night, lying on the bed, relaxing all over the body, stacking the palms of both hands on the navel, first squatting 100 times clockwise, then counterclockwise 100 times, the time is moderate. Long-term adherence helps increase gastrointestinal motility.
2. Excessive contraction of the anorectal muscles: The muscles around the anus are tightly contracted, and it is difficult to produce the intention, so that the stool is retained in the intestine for a long time to cause constipation. The levator ani exercise is very helpful. The levator ani can be performed while sitting, lying and standing. The method is as follows: abdomen, slowly exhale, and consciously raise the anus upwards. When the air in the lungs is exhaled as much as possible, hold the breath and keep the anus for 2 to 3 seconds, then relax the whole body and let the air enter naturally. In the lungs, rest for 2 to 3 seconds, repeat the above actions. 1 or 2 times a day, 30 or 5 minutes each time.
3. Dietary factors: lack of cellulose in food, lack of coarse grains and fruits, and low drinking water are all causes of constipation. This aspect should be adjusted from the diet. Complement the lack. Natural plant sleeping vegetables extracts spleen and digestion, ginger root extract can warm stomach.
4. Bad spirit, poor health: elderly people with mental stress and depression have symptoms of constipation. Some chronic diseases, such as hypothyroidism and neurasthenia, can also cause constipation symptoms, which requires treatment for the disease.
5. Drug factors: Some elderly people have cardiovascular disease requiring long-term medication, and some antihypertensive drugs may also cause constipation. At this time, it is necessary to respond to the disease, and alleviate it through various methods such as diet, drinking water, and abdomen.
6. Anorectal diseases cause constipation: Chronic colitis is mostly caused by damp heat and phlegm, spleen and kidney yang deficiency, qi and blood deficiency, qi stagnation and blood stasis, eating disorders, overwork, mental factors, but also constipation, constipation and diarrhea Performance. Patients with acne are often afraid of defecation due to ruptured or painful hemorrhoids, and constipation is formed over time. Medicinal planting grass leaves heat clearing; corn ear extract antibacterial and anti-inflammatory; red clover extract antioxidant and pathogenic microorganisms; licorice extract kills staphylococci.
Examine
an examination
Related inspection
Colonoscopy
Diagnosis of intractable constipation: The cause of intractable constipation is a functional gastrointestinal disorder, that is, no physical lesions can be found. It is caused by nervousness, stress, gastrointestinal motility disorder, or constipation, forming a vicious circle. , leading to habitual constipation. Insert a special manometer into the anus, through the instrument's display, you can get a lot of information, including the pressure of the anal sphincter, rectal compliance, sensory sensitivity at the rectum, so that the patient feels when there is a defecation reaction, then Try this reaction again, inspiring the bowel movement to feel the removal of feces
Diagnosis
Differential diagnosis
Differential diagnosis of intractable constipation:
Intractable constipation occurs mostly in the elderly and refers to a long-term, chronic functional constipation. However, some scholars believe that habitual constipation is not limited to functional constipation. It also includes colonic constipation and rectal constipation. Therefore, elderly people with habitual constipation should seek medical attention early and find out the cause of constipation. In general, intractable constipation has the following four characteristics:
1 Intractable constipation is a type of disease that gradually causes difficulty in defecation at different ages due to congenital knot and rectal anatomical variation.
2 The essence of intractable constipation is chronic incomplete intestinal obstruction, which is classified into colonic, rectal, and mixed types because of its different obstructive sites.
3 Refractory constipation is a non-surgical treatment that does not work, and a type of disease that cannot be cured by medical treatment.
4 Refractory constipation is not a functional but a knot and rectal lesion with obvious organic changes.
