Chronic Constipation - Causes, Symptoms, Diagnosis and Treatment
Chronic constipation - Chronic disorder of the intestine functions, accompanied by difficulty in emptying and slowing or permanent impairment of defecation. It may be organic or functional, primary or secondary. Chronic constipation is manifested increasing intervals between acts of defecation, stool seal, a sense of incomplete evacuation, straining need to strengthen and taking laxatives. Diagnosis is based on complaints, medical history, data inspection and abdominal palpation, rectal examination, laboratory tests and instrumental investigations. Treatment - diet, laxatives, non-pharmacological therapy.
Chronic constipation
constipation (chronic constipation) - a symptom, including a reduction in the frequency of defecation acts and expressed difficulties in the process of bowel movements, to identify for six months or more. Chronic constipation is polyetiological pathological condition can develop when organic lesions of the colon, disorders of the nervous and endocrine regulation of gastrointestinal activity, hypochondriacal personality disorders, diet violations, and so on. D. We consider the modern proctology and gastroenterology, as the most important social and medical problem.
Pathology is extremely widespread. Experts believe that chronic constipation varying severity to suffer 30-50% of adults and 5-20% of US children and the countries in Europe. Accurate statistics on the incidence of constipation are absent in Russia, because patients are embarrassed or do not consider it necessary to see a doctor, and often self-medicate, buying laxatives alone. With age, the likelihood of developing chronic constipation increases. The treatment carried out by specialists in the field of proctology and gastroenterology.
Criteria for chronic constipation
Non-specialists often believe that constipation is a condition in which the act of defecation is performed less frequently than normal, with normal bowel movements believe 1 time per day. This approach leads to self overdiagnosis of chronic constipation and unjustified acceptance of laxatives. Meanwhile, the physiological norm is conventionally considered the frequency of bowel movements 3 times a day to 3 times a week. Chronic constipation is characterized by not only increasing the time interval between bowel movements, but also reduce the amount of fecal matter, increased density, dryness and hardness of stool, and the sensation of incomplete bowel evacuation after defecation. Chronic constipation can be observed as all these features, and one or two of them, with the severity of a particular trait can vary greatly.
Given the high variability of the manifestations of chronic constipation, the Rome Foundation compiled and published criteria for the diagnosis of this pathology. At present these criteria are used in clinical practice, both foreign and Russian experts. According to the "Rome criteria" chronic constipation is diagnosed when the patient within six months there are one or more symptoms of the disease, in this case for three months, revealed two or more of the following symptoms:
gastritis, peptic ulcer disease), adhesive disease, polyneuropathy in diabetes mellitus, diseases and traumatic damage to the central nervous system, accompanied by a disorder of the nervous regulation of intestinal activity, and obesity, portal hypertension, pulmonary emphysema, and heart failure.
Chronic constipation can occur with certain psychiatric disorders, in particular - for depression. Violations of the chair is often observed in the period of gestation. This pathology is often diagnosed in older people, which is associated with age-related slowing of the passage of intestinal contents and the weakening of the muscles involved in the act of defecation. Medication develop chronic constipation while taking antidepressants, opiates, ganglioblokatorov and some other drugs. Sometimes the cause of constipation can not be established.
If you have chronic constipation great importance is the formation of a vicious circle - and deepening mutual combination of several mechanisms that underlie disorders of the chair. Among the mechanisms of development of chronic constipation - inability to commit an act of defecation in the conditions of stress, uncomfortable or unfamiliar surroundings, the unavailability of toilets, lack of exercise, defecation delay reactive under conditions of constant mental and emotional stress, taking certain medications, etc.
diarrhea, accompanied by a discharge of liquid feces with mucus.
Possible deterioration of appetite, burping air and fetid breath. Persistent problems with defecation, abdominal discomfort and other symptoms of chronic constipation adversely affect the psycho-emotional status and health of patients. In the presence of underlying disease, provoking constipation in patients with chronic constipation symptoms of underlying pathology revealed: pain in the pit of the stomach, heartburn, nausea and vomiting in the defeat of the stomach; shortness of breath, easing breathing and barrel chest with emphysema; shortness of breath, palpitations, heart pain and swelling of the heart in heart failure, and so on. d.
Crohn's disease, colon cancer, diverticulosis, malformations and acquired abnormalities of the colon).
patients with chronic constipation survey plan includes a survey (asking complaints and medical history), general inspection, inspection and palpation of the abdomen, digital rectal examination, radiological studies (plain radiography of the abdominal cavity, barium enema) and colonoscopy. Depending on the intended disease doctor can prescribe to a patient with chronic constipation bowel biopsy coprogram, fecal occult blood, bacteriological examination of feces, Manometric method (anorektometriyu, sphincterometry), as well as consulting a therapist, endocrinologist, cardiologist, pulmonologist, and other specialists, laboratory and instrumental tests to identify diseases of other organs and systems.
massage and electrical stimulation. In inflammatory diseases of the bowel purgatives are contraindicated. Forecast determined the cause of chronic constipation and willingness of the patient follow the doctor's recommendations.