Constipation

Constipation is the polyethological syndrome of a prolonged delay of defecation. There are constipations: 1) neurogenic (with functional or organic diseases of the central nervous system, frequent conscious suppression of reflex to defecation, conditioned by living or working conditions - lack of toilet, work of driver, seller, etc.); 2) reflex (with organic lesions of the digestive system, as well as other organs and systems), including proctogenic ones; 3) toxic (with chronic poisoning with lead preparations, morphine, nicotine, nitrobenzene, long-term admission in large doses of anticholinergics and antispasmodics); 4) "endocrine" - with a decrease in the function of the pituitary gland, thyroid gland, ovaries; 5) alimentary (with insufficient intake of fiber from the diet); 6) hypokinetic (with insufficient physical activity, mostly sedentary lifestyle); 7) mechanical (due to narrowing of the intestine with a tumor, scars or congenital pathological lengthening of the colon, underdevelopment of its intramurabic nerve plexuses - megacolon, Hirschsprung's disease). The listed reasons can cause predominantly motor disorders of the intestine or a violation of secretion and absorption, or vasomotor disorders; However, in most cases, the end result (clinical manifestations) is a consequence of a combination of several disorders.

Symptoms, course. A prolonged delay of defecation is characteristic. With atonic constipation, stools are abundant, decorated, sausage-shaped; Often the initial portion is very dense, larger than the norm, the diameter, the final - semi-formalized. Defecation is carried out with great difficulty, very painful; As a result of tearing of the mucous membrane of the anal canal on the surface of stool masses, veins of fresh blood may appear. With spastic constipation, stools take the form of sheep stool (a fragmented stool). Constipation is often accompanied by flatulence, a feeling of pressure, expansion, spastic pain in the abdomen. Long constipation is often accompanied by fatigue, lethargy, decreased efficiency. X-ray examination reveals a slowdown in the movement of stool masses through the intestine.

Treatment. With constipation caused by organic diseases of the colon, they are treated. With atopic constipation in the daily diet increase the number of foods containing a large amount of vegetable fiber (vegetables, fruits). Prunes, beets, carrots are especially shown. With spastic constipation, the diet should be more gentle, meat and fish are prescribed in boiled form, vegetables and fruits - in mashed or in the form of mashed potatoes. It is advisable to regularly take fresh yogurt and other lactic products. Patients with atonic constipation are recommended a more active way of life, therapeutic gymnastics, circular shower, sub-aqua baths. With spastic dyskinesia of the intestine, paraffin applications, coniferous baths and other thermal procedures that help to relieve spasms of the intestine help. If the cause of constipation is primarily an excessive psychoemotional lability, prescribe sedatives and tranquilizers.

With spastic constipation of the intestine, spasmolytics are shown (papaverine hydrochloride is 0,04 g 3-4 times a day inwards, 0.02 g in the form of suppositories in the rectum 1-2 times a day or 1-2 ml 1-3 times in Day of penicillin, but-shpa on 0,04 g inside or p / k2-3 times a day, etc.), cholinolytic agents (atropine sulfate, platifillin hydrotartrate, etc.), as well as combined preparations ( Bellatamilanadr.).

For agonistic constipations, laxatives are used as symptomatic therapy: phenolphthalein, rhubarb, preparations of buckthorn, senna, vaseline oil inside (20-30 ml), etc.

The prognosis with timely prescribed treatment is good.