Constipation: chronic and acute, causes, treatment, diet, home remedies

Constipation is a syndrome characterized by delay and difficulty in defecation.

There are two types of constipation:

• spicy
• chronic.

You can read about constipation during pregnancy in this article .

Chronic form

Chronic constipation is a disorder of intestinal function in which bowel movements occur systematically less than 3 times a week. But constipation is characterized not only by infrequent stools, but also by hard, stingy feces.

The consistency of stool is determined by the amount of water in it. The appearance of stool is determined using the Bristol scale . A stool weight of less than 35 g is also considered a criterion for constipation. Factors such as difficulty defecating, a feeling of incomplete bowel movement, and abdominal discomfort are also taken into account.

Acute form

Acute constipation is the absence of stool for several days. If gases accumulate along with the absence of stool, the development of intestinal obstruction can be assumed. When constipation increases rapidly over several weeks, a tumor may be the cause.

With diverticulitis and other inflammatory diseases, constipation is usually preceded by severe abdominal pain, fever and other signs of the inflammatory process.

What is constipation?

During normal bowel function, a person's rectum Feces accumulate in the sigmoid colon , then move into the ampulla of the rectum, and this causes a reflex urge to defecate. In healthy people, the urge occurs regularly in the morning after getting out of bed or shortly after breakfast.

Defecation itself is controlled by the central nervous system and a healthy person can suppress the urge to have a bowel movement. Regular disruption of any of the mechanisms of this complex process can lead to the development of constipation.

The habit of suppressing the urge to defecate leads to overstretching of the rectum, suppression of reflex signals and the development of so-called habitual constipation. In addition, constant overflow of the rectum without emptying causes its enlargement and leads to atony (weakness) of its wall.

As a result, the urge to defecate occurs only when the rectum is full. This phenomenon is called an “inert” rectum. But this also causes “inertia” of the colon. Since in this case only movements that mix feces are preserved in the colon. The movements that move it along the intestine are significantly weakened or absent.

This causes the transit of feces through the intestines to slow down. It stays in the large intestine longer than normal. In this case, additional absorption of fluid occurs, which leads to a decrease in the volume of feces and an increase in its density.

Causes

• The causes of constipation are varied. It is important to understand that constipation is not a disease, but a symptom. This disorder is accompanied by many diseases of both the abdominal organs, the brain and spinal cord and the endocrine system.
• The most common cause is a disorder in the muscle layer of the intestine. These are dyskinetic constipations, and as studies have shown, they are characterized by a combination of spastically contracted and relaxed areas of the intestine.
• Contrary to the popular belief that the leading role in the development of constipation is played by insufficient physical activity and a diet poor in fiber, these causes occupy a very modest place in the general statistics of diseases. Although in the system of treating constipation these two factors are given due attention.
• A common cause of constipation is impaired reflexes that occur with peptic ulcers, gastroduodenitis, cholecystitis and adhesions in the pelvis.
• In patients with heart failure, pulmonary enphysema, and obesity, the cause of constipation can be a weakening of the muscle tone of the diaphragm and the anterior abdominal wall.
• Constipation occurs more often in older people after 65 years of age, which is associated with muscle hypotension.
• A functional bowel disorder called irritable bowel syndrome may also be accompanied by constipation.
• Intestinal obstruction associated with a tumor, the formation of fecal stones, compression of intestinal loops by tumors of other organs more often leads to disorders in which either constipation or diarrhea occurs.
• Constipation from medications can develop as a side effect from taking a number of medications. This constipation resolves soon after stopping the medication. This type of constipation can also be caused by uncontrolled use of medications for diarrhea. This occurs either with long-term use of such drugs, or with loss of potassium as a result of taking the drugs.

Symptoms

Functional constipation is not characterized by sharp pain. They are accompanied by a feeling of discomfort and fullness in the abdominal cavity when stool is retained.

Intense, spasmodic pain before and during bowel movements are characteristic of processes of narrowing of the intestinal lumen (stenosis).

Pain in the rectum and anus is often accompanied by the appearance of blood during bowel movements. The most common causes of this are hemorrhoids, sphincteritis and anal fissures.

Prolonged stay in bed, as well as systemic diseases such as diabetes, scleroderma and myxedema also cause constipation.

Organic (mechanical) intestinal obstruction is characterized by constipation, bloating, often asymmetry of the abdomen, increased peristalsis, sometimes visible to the eye, sonorous noises and splashing noises during auscultation (listening).

Examination methods

First of all, the survey determines whether constipation is acute (sudden) or chronic.
In case of acute onset of constipation, a possible connection with medications is investigated. Next, an obstruction of an organic nature is diagnosed.

Instrumental diagnostics for acute constipation include plain radiography of the abdominal cavity in an upright position, sigmoidoscopy, examination of the colon with a barium enema and colonoscopy.

Mandatory examination methods for all patients with constipation without exception include stool analysis for occult blood, examination of the internal anal sphincter with a finger, sigmoidoscopy and colonoscopy or polypositional irrigoscopy with double contrast.

To determine in more detail the degree of motor dysfunction, intestinal transit time is examined. This is done using various markers.

Disorders of the neuromuscular coordination of defecation, resulting from impaired fecal output, are detected using anal manometry.

Treatment

If constipation is functional, then you need to give up the habit of constantly taking laxatives and doing enemas. This only makes the situation worse. You should learn to regulate your bowel movements through proper nutrition, exercise, or simply a more active lifestyle.

In more complex cases, constipation is treated with medications under the supervision of a doctor.

And to eliminate obstruction and in other difficult situations, surgical intervention is used.

What to do if you are constipated?

There are basic rules of behavior , the observance of which can cure or prevent constipation:

1. Regular movement. Sports or even just a walk will tone the intestines and prevent “inert” bowel syndrome.
2. Gymnastics, especially exercises for the abdominal muscles, also stimulates the intestines and strengthens the muscles of the diaphragm and the anterior abdominal muscle, which play a leading role in the act of defecation. It is important when performing exercises not to hold your breath, but to breathe consciously and deeply. The resulting pressure in the abdominal cavity acts as a abdominal massage for constipation.
3. Make sure you drink enough. Nutritionists recommend drinking about 1.5-2 liters per day. Water and unsweetened herbal teas work well.
4. You should not regularly suppress the urge to defecate for a long time.
5. Active recreation relieves stress. Relaxation techniques such as yoga or autogenic training may help. In addition, a warm bath or walk will help relieve stress after a busy day and relax.
6. Always allow enough time to go to the toilet, especially in the morning. Many people, being late for work, neglect the morning toilet, although it is at this time that the intestines are most active.
7. Abdominal massage can help relieve constipation and is a useful adjunct to treatment, especially for chronic constipation. You can also perform the massage yourself. Abdominal massage for constipation is best performed while lying down: starting from the lower right part of the abdomen, make circular movements clockwise.
8. Use of probiotics.

Diet

For constipation, diet No. 3 .

Wheat bran is used to improve intestinal transit and reduce intraintestinal pressure.

Wheat bran is first poured with boiling water and after 30-60 minutes added to soup, compote or kefir. The dietary fiber contained in bran absorbs water, and since it is not digested, it increases the volume of feces and makes it less solid.

Nowadays, along with bran, they use ready-made mixtures containing dietary fiber that are pleasant to the taste. For example, division and mucofalk.

Constipation pills

During drug treatment, the features of motor dysfunction are taken into account and drugs are prescribed that enhance it or relieve spasms.

In the complex treatment of constipation, drugs with a choleretic effect play an important role.

At the first stage of treatment, it is sometimes advisable to prescribe laxatives.

Modern laxatives can be divided into four groups.

• Osmotic or saline laxatives that retain water molecules.
• Drugs that inhibit the absorption of water in the intestines.
• Drugs that increase the volume of stool.
• Stool softeners.

Home Remedies

There are a number of effective home remedies for constipation. However, they have an individual effect on everyone. Therefore, you should first try a little at a time and understand which home remedy for constipation is suitable for you.

1. Sauerkraut and sauerkraut juice are effective home remedies for constipation due to the lactic acid they contain. But in sensitive people they cause flatulence.
2. Fermented milk products such as yogurt, curdled milk or kefir also contain lactic acid, which acts as a mild laxative.
3. Soaked dried fruits such as prunes or dried figs contain a lot of fiber, which has a positive effect on digestion.
4. All types of plums and plum juice are an excellent natural laxative.
5. Kiwis and apples contain a lot of fiber and thus have a positive effect on intestinal activity.
6. Fruit juices, such as pear or pineapple juice, can also serve as a natural laxative. It is especially effective to drink them in the morning on an empty stomach.
7. Mineral water with a high sulfate content (minimum 1200 mg/l) stimulates intestinal activity and can act as a laxative.
8. Another popular home remedy for constipation is castor oil. In the intestines, pancreatic enzymes and bile acids break down castor oil into acid and glycerol. Acid stimulates intestinal activity, and glycerin makes stool more pliable.
9. Castor oil should not be used by pregnant women, as it stimulates not only the intestines, but also the uterus.
10. Every morning before breakfast you should drink 1 glass of warm water, which stimulates intestinal activity.
11. In the morning on an empty stomach, swallow 1 tbsp. l. olive oil - this softens the stool.