Refractory constipation (constipation)

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Constipation is a common clinical symptom, yesterday a young female, has a 3 year history of chronic constipation, usually very difficult to


Constipation is a common clinical symptom, yesterday a young female, has a 3 year history of chronic constipation, usually very difficult to take a lot of shit, drugs, including traditional Chinese medicine and Western medicine were taking effect, you poor, colonoscopy see colonic mucosa obvious melanosis. So how to treat constipation:

1, western medicine differential diagnosis:

First of all, constipation is to distinguish between functional constipation or organic constipation, functional constipation (functionalconstipation):

There are 5 reasons for not good to remember, if according to the cause of each combination of the first letter, it is relatively simple, as follows:

Mmm, DD (meal, medication, myasthenia muscle weakness, disorder of colon, disruption and other factors leading to changes in bowel habits) bowelhabits 3 married to 2 DD mm (to).

Organic constipation (organicconstipation) has 5 types of diseases to be identified: rectal and anal diseases, systemic diseases, drugs, colonic obstruction or incomplete obstruction, abdominal pelvic disease and the use of special drugs. Even in the clinical experience of simple constipation in the strict sense of the need to go through the above differential diagnosis in order to avoid misdiagnosis.

2, Chinese medicine to cold and heat constipation constipation, to classification of diagnosis and treatment for cold, constipation with Aconite and Marenrunchang pills, eat less fruit. Must first understand the concept of constipation, if natural defecation (non laxatives defecation) less than three times a week or dry stool, or stool is not only called stem discharge difficult for constipation. Under normal circumstances, intermittent defecation for an average of 18 - 37 hours, due to individual differences, intermittent defecation are quite different, as long as the stool is not dry, defecate unobstructed, no pain, no constipation. Come Xiaoling anorectal Hospital Affiliated to Shandong University of Traditional Chinese Medicine

Constipation is not an independent disease, many diseases are likely to occur constipation, bad habits are also prone to constipation, constipation, the following reasons:

1 dietary factors;

If the amount of food is small and fine, crude fiber food is less, the formation of feces for a long time, most of the water is absorbed, so dry stool and difficult to discharge.

2 bad defecation habits, no regular defecation habits

Usually busy with work, travel, life is not the law, even if there will be Italy, but because the surrounding environment is not allowed to tolerate the meaning for a long time, the feeling of the rectum stool pressure decreased, resulting in a lack of meaning, which is often one of the most common complaints of patients with constipation. Some people squat toilet when reading newspapers, for this is not conducive to defecation reflex, defecation time.

3 elderly, bedridden people, many because of weak muscle force help defecation, stool is not dry, but difficult to discharge. In older women, because of perineal laxity in the defecation, abdominal pressure, the anterior wall of the rectum to forward, defecation pressure toward the vagina without direction toward the anus, feces accumulate protrusion caused by outlet obstruction. The main performance is: difficult defecation, anal obstruction, defecation, anal pressure dispersion, incomplete emptying, some patients with hand pressure around the anus or vagina, or even need to be hand inserted into the anus to facilitate defecation, others use toilet paper rolls or soap strips into the anus to facilitate defecation, some patients with hematochezia anal pain.

4 intestinal lesions.

Colorectal cancer is swollen, chronic hyperplastic intestinal inflammation, postoperative intestinal adhesion can make intestinal stricture, fecal difficult. Intestinal diseases caused by constipation, there are some manifestations of intestinal diseases, such as colorectal manifestations except constipation will have mucus and blood stool, defecate not feeling. Chronic inflammatory bowel disease, abdominal pain and constipation diarrhea alternating. Constipation exhausted stool as hard as sheep. Postoperative intestinal adhesion with the progression of the disease, constipation, increased performance.

5 neurological disorders

Brain tumors, Parkinson's disease, sacral nerve or spinal cord injury, spinal cord tumors, multiple sclerosis, etc. can lead to nerve conduction disorders, resulting in defecation difficulties.

6 abnormal colonic movement.

Such as irritable bowel syndrome, one of which is called spastic constipation, that is, the following abdomen, especially the lower left abdominal pain and constipation as a prominent symptom, but also some of the symptoms: diarrhea and constipation alternately. If the child is born with constipation, constipation after the rapid increase, accompanied by abdominal distension should be considered for the possibility of Hirschsprung's disease (congenital nerve cell deficiency).

7 endocrine disorders and metabolic diseases can cause constipation.

Pituitary insufficiency, hypothyroidism, diabetes and other endocrine disorders, hypercalcemia, dehydration, lead poisoning, etc. are often caused by constipation of pheochromocytoma. Late pregnancy, due to the role of progesterone, the muscle power reduction can also cause constipation.

8 drug induced constipation

Application of codeine, antidepressants, iron, anticholinergic drugs, these drugs will affect the intestinal peristalsis caused by constipation. Long service will make evacuant, reduce susceptibility to rectal faecal irritation, drug dependence, once the withdrawal will cause constipation.

Constipation patients should go to the hospital to check, find the cause of constipation. Such as intestinal organic lesions, still need surgery, such as intestinal functional lesions, also need to treat the syndrome differentiation of traditional Chinese medicine, oral Chinese medicine, acupuncture, massage method can cure. Eat more vegetables, drink plenty of water is only used for the prevention of constipation, or constipation is an adjuvant treatment. The occurrence of constipation should be adjusted in a timely manner, timely inspection. I met a 70 year old woman due to constipation for a month, after examination found that colon cancer, timely surgical treatment.

Most of the people through the Chinese medicine treatment can relieve constipation symptoms, combined with diet therapy, exercise, avoid sedentary time long lie, a daily habit of defecate, maintain good mood, will make the stool.

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