Constipation

Constipation (or constipation) is a dysfunction of the intestines, which is expressed in an increase in the intervals between bowel movements compared to the individual norm or in systematically insufficient bowel movements. Constipation is considered a chronic delay in bowel movement for more than 48 hours, accompanied by difficulty in defecation, a feeling of incomplete evacuation with the passage of a small amount of hard stool (less than 100 g).

The etiology of constipation can be different. Functional constipation occurs with insufficient dietary intake of fiber and water (alimentary constipation) and with insufficient physical activity, including in postoperative patients, after myocardial infarction, and with a predominantly sedentary lifestyle (hypodynamic constipation). Organic damage to the intestine causes constipation when the lumen of the colon and rectum is blocked (for example, with narrowing of the intestine by a tumor, scars, mechanical compression of the rectum from the outside), dysfunction of the muscle layer of the colon wall (for example, with irritable bowel syndrome, systemic scleroderma), painful defecation (anal fissures, thrombosis of external hemorrhoids, proctitis). Extraintestinal causes underlie neurogenic constipation (with functional or organic diseases of the central nervous system, frequent conscious suppression of the reflex to defecate due to living or working conditions - lack of a toilet, work as a driver, salesman, etc.), "endocrine" (with decreased function of the pituitary gland, thyroid, parathyroid glands, ovaries), toxic (in case of chronic occupational poisoning with lead, mercury, thallium), medicinal (caused by narcotic analgesics, antacids containing aluminum, anticholinergics, antispasmodics, iron preparations, bismuth, calcium antagonists, constant use laxatives, etc.). The listed reasons can cause predominantly motor disorders of the intestines (spastic, atonic), or disturbances of secretion and absorption, or vasomotor disorders; however, in most cases, the final result (clinical manifestations) is the result of a combination of several disorders.

In some patients, examination fails to identify the cause of chronic constipation; in these cases, the presence of idiopathic constipation is stated.

Symptoms of constipation can be varied, but a long delay in defecation is typical. With atonic constipation, feces are abundant, shaped, sausage-shaped; Often the initial portion is very dense, larger in diameter than normal, the final portion is half-formed. Defecation is carried out with great difficulty and is very painful; Due to tears in the mucous membrane of the anal canal, streaks of fresh blood may appear on the surface of the stool. In irritable bowel syndrome, stool takes on the form of sheep feces (fragmented stool). Constipation is often accompanied by flatulence, a feeling of pressure, expansion, and cramping pain in the abdomen.

To diagnose constipation, the doctor examines the patient, including anamnesis (medical history), physical examination, and a number of additional tests (for example, rectal examination, colonoscopy, x-rays, etc.). Treatment for constipation depends on its cause. In case of functional constipation, it is recommended to increase the consumption of foods rich in fiber, increase physical activity and take mild laxatives. For organic causes of constipation, surgery or other specialized therapy may be required.

Overall, constipation is a common condition that can have many causes and manifestations. Early consultation with a doctor and proper treatment will help cope with this problem and avoid serious complications.