Constipation is slow, difficult, or insufficient bowel movements. It is considered normal to have a bowel movement at least once every one and a half days or two days. However, a number of researchers are of the opinion that bowel movements should be daily, or more correctly, every morning. We can talk about constipation if there is no bowel movement for at least 36 hours, but the person followed a normal diet, did not take strong laxatives the day before or did not cleanse the intestines.
Sometimes the situation with difficulty in bowel movement goes too far. A week of constipation or no bowel movements for 7 days is a serious condition that requires immediate attention. It is necessary to consult a doctor to rule out serious pathologies and obtain the necessary prescriptions.
What is constipation
— Constipation is a popular concept, it is not very accurate. By this word, people sometimes mean different conditions, and their ideas differ from those of doctors. For example, patients often refer to constipation as simply infrequent bowel movements. In medicine there is a specific term: constipation. It refers to a disorder in which bowel movements (bowel movements) occur less than once every three days. Very often, patients complain of constipation, but in fact they do not have rare stools, but, for example, hard ones. These are different things. Therefore, as doctors, we do not use the ambiguous term “constipation” in our practice.
The main function of the large intestine is the absorption of water from intestinal masses. And the longer they stay in its lumen, the more dehydrated and hard they become. Normal emptying occurs when their consistency is soft. And the harder the stool, the more difficult and dangerous it is to defecate. First, bulky, hard stool can lead to anal fissures. Secondly, due to difficulty in defecation, intra-abdominal pressure increases, and this contributes to the enlargement of hemorrhoids.
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Prevalence and classification
On average, 15 to 30 percent of the population has difficulty defecating. Constipation can occur in people of any age, including children. People over 60 years of age are more likely to suffer, which is due to slower bowel movements and a lack of digestive enzymes. According to statistics, women complain of constipation more often than men.
Constipation can be temporary or chronic. Temporary discomfort for several days, then bowel movements return to normal. Chronic constipation is said to occur if it persists for more than three months.
Separately, there is the so-called situational constipation. It occurs as a result of bed rest, shift work, psycho-emotional stress, etc.
Causes of constipation
Here are the main causes of constipation:
- Poor nutrition . When the diet is low in fiber and liquid, the stool becomes hard and takes a long time to pass through the intestines.
— Irritable bowel syndrome . This is a functional disease in which alternation of constipation and diarrhea is often observed. It does not have a clearly established cause, and disruption of the nervous system plays a major role in its development.
— Physiological changes after childbirth . In some women, after the birth of a child, the ligaments of the pelvic organs weaken, and the nerves of the pelvis begin to conduct signals worse. This disrupts normal bowel function. In such a situation, defecation can be painful and especially difficult.
Why is it dangerous?
The consequences of constipation in women affect the entire body if treatment is not carried out in a timely manner.
Irregular bowel movements lead to poisoning of the body with toxins that are absorbed in the intestines.
General health worsens, loss of appetite, apathy, pale skin, and decreased performance are observed. It is important to consider what causes constipation in women. These are the reasons that can be the source of the most unpleasant symptoms.
Constipation causes the following complications:
- secondary colitis;
- proctitis, sigmoid colitis;
- reflux enteritis;
- abnormalities of the biliary tract;
- haemorrhoids;
- anal fissures;
- rectal cancer;
- paraproctitis.
Small bowel cancer is a controversial phenomenon because multiple risk factors must be present simultaneously. Long-term disturbances lead to inflammatory processes. Chronic inflammation increases the risk of cancer. Combined with genetic predisposition, this significantly increases the risk of developing colorectal cancer.
How constipation affects health and well-being
Feelings of heaviness, bloating, as well as rumbling and other sound phenomena can make a person very nervous. Long and painful bowel movements can be even more debilitating, especially if constipation becomes chronic. Prolonged presence of stool in the intestines may be accompanied by symptoms of intoxication. This happens when harmful substances that should be eliminated from the body with intestinal contents are absorbed back into the blood along with water. In such cases, a person feels unwell, headaches, fatigue, and weakness. This often affects the condition of the skin: it acquires an earthy color, becomes sluggish and flabby.
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Symptoms
The frequency of bowel movements varies greatly from person to person. Some “walk big” every day, others do it once every 2-3 days. According to experts, defecation from 3 times a day to three times a week is considered normal.
Constipation is usually spoken of in the following cases:
- bowel movements less than three times a week;
- defecation requires a lot of effort;
- stool has a lumpy and very hard consistency due to prolonged residence in the intestines;
- feeling of incomplete evacuation of feces;
- a feeling of obstruction in the rectum.
Some people may have normal frequency of bowel movements, but straining and hard stools. In such cases, a subjective feeling of constipation occurs.
Colonoscopy is necessary if constipation is accompanied by painful bowel movements and bleeding
When Constipation Can Be Deadly
A tumor in the large intestine, whether benign or malignant, can interfere with the passage of stool. At first, when the intestine is not yet completely blocked, it causes a feeling of bloating. If you do not seek help in such a situation, the tumor may completely block the intestinal lumen, and then acute intestinal obstruction occurs. This situation requires emergency surgery. Unfortunately, the effectiveness of such an operation is often quite low. If the intestine swells very much in front of the narrowing site, it may rupture. In this case, the stool enters the abdominal cavity, and the likelihood of death in such a situation is very high.
Diagnostics
At the initial appointment, you need to inform the doctor about the frequency and nature of stool, discomfort in the abdomen, and indigestion. After a general examination, palpation and percussion, additional diagnostics may be required. It is necessary to exclude a primary disease.
According to indications, the following examinations are prescribed:
- blood tests (general analysis, liver tests, amylase, thyroid hormones, etc.);
- stool analysis (coprogram);
- ultrasound examination of the abdominal organs;
- colonoscopy.
The last research method, colonoscopy, is especially important if bowel movements are accompanied by pain in the rectum or bleeding. During an examination with a fibrocolonoscope, the doctor can diagnose polyps, fissures, erosions or neoplasms of the large intestine and, if necessary, perform a biopsy.
How to avoid constipation
First of all, you need to eat right. Your diet should have enough fiber from vegetables and fruits. But there should not be too much fruit, since they contain a lot of glucose, and it can cause fermentation in the intestines and, accordingly, excessive formation of gases. But vegetables such as zucchini, cabbage and bell peppers can be eaten in almost unlimited quantities: the plant fiber contained in them is not digested and does not serve as a source of energy for our body. It serves as a good breeding ground for beneficial bacteria, which multiply well in such conditions and, in turn, also contribute to the proper digestion of food and the formation of soft stools. Fiber fiber, like a sponge, retains water and plays the role of a frame on which food debris sticks, forming soft, loose stool.
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Physical activity is very important to prevent constipation. The movement of skeletal muscles contributes to the good functioning of the muscles of internal organs, including the colon. The World Health Organization recommends moving for at least 30 minutes a day. For those who move a lot and exercise at least 3-4 times a week, the colon works more actively, and this is a good prevention of constipation.
Some people require large amounts of not only vegetables, but also preparations with plant fiber to prevent constipation. Most often they contain flax seed powder. It is good to dilute it with water and drink it in the morning, thanks to this the body will receive a sufficient amount of indigestible coarse plant fiber. You can also take bran - wheat, rye or oat. Their usual dose is 2 tablespoons. To make the bran swell, it is good to brew it with boiling water, pour it with water overnight, or dilute it with yogurt. And you can eat it instead of porridge or eat it with porridge for breakfast. Preparations made from microcrystalline cellulose are also used. It's not fiber, but it works in a similar way. As for laxative medications, it is better to take them not on your own, but as prescribed by a doctor.
Treatment
Help before diagnosis
The main method for eliminating constipation in adults, which can be used at home, is changing your diet. It is important to increase the amount of plant fiber, which helps increase the volume of feces and stimulates the urge to defecate. It is recommended to take fiber in the form of wheat bran (3-4 tablespoons per day); whole grain bread, fresh fruits and vegetables should be added to the diet.
It is necessary to increase fluid intake to 2.5 liters per day, which helps soften the stool. To stimulate intestinal motility, you should add regular physical activity, try to empty your intestines at the same time, in the morning after breakfast. If constipation is combined with severe pain in the abdomen, fever, or blood in the stool, you should consult a doctor.
Conservative therapy
Medications prescribed for the treatment of constipation in adults are selected taking into account the clinic and the cause of defecation disorders. To quickly completely empty the intestines and prevent intoxication, cleansing or siphon enemas with hypertonic solutions are given. To reduce pain in rectal pathology, therapeutic enemas with oils and anesthetics are administered. For the treatment of constipation use:
- Laxatives
. Osmotic medications and bisacodyl rectal suppositories, which stimulate peristalsis, are recommended. The frequency of administration and dosage of medications are strictly controlled so as not to aggravate the patient’s condition. The course of treatment is no more than 2-3 months. - Enterosorbents
. The drugs reduce gas formation in the intestines, reduce the manifestations of flatulence and pain in the abdomen. To improve digestion and eliminate the cause of constipation, take probiotics that improve colon microflora. - Antibiotics
. For colitis and other inflammatory processes of bacterial etiology, agents that act exclusively in the intestinal lumen are indicated. Parasites are eliminated using specific anthelmintic drugs. - Antispasmodics
. They are used to reduce pain and spasm of the rectal sphincters, which makes defecation easier in adults. For unbearable pain, they are combined with non-narcotic analgesics and physiotherapy methods. - Detoxification solutions
. To eliminate poisoning as a cause of lack of bowel movements, saline solutions are used, which are administered in large volumes, and the technique of forced diuresis. In case of metal intoxication, complexones are prescribed.
What are the types
These disorders may be primary or secondary. In the first case, this occurs against the background of congenital or acquired anomalies. Secondary disorders appear due to various diseases and injuries. There are also idiopathic ones, the causes of which are not clear.
Depending on the course of constipation, they can be of atonic or spastic type. The second option is more common due to poor nutrition and stress. In the spastic form, there is increased tension in the intestines, which prevents stool movement. With atonics, on the contrary, peristalsis slows down and feces do not pass through.
In difficult cases, several diagnostic methods are used:
- palpation, drums;
- general stool analysis;
- dysbacteriosis test;
- occult blood test;
- instrumental studies.
