I'm always constipated recently, and I pay great attention to my diet. I eat a lot of coarse grains and fruits. Why is constipation still happening? What should I do?

Constipation can be divided into two categories: organic and functional. 1. Organic causes mainly include: (1) organic intestinal lesions: intestinal stenosis or obstruction caused by tumor, inflammation or other reasons. (2) anorectal diseases: rectal prolapse, hemorrhoids, rectocele, puborectal muscle hypertrophy, pubic separation, pelvic floor diseases, etc. (3) Endocrine or metabolic diseases: diabetes, hypothyroidism, parathyroid diseases, etc. (4) Systemic diseases: scleroderma, lupus erythematosus, etc. (5) Nervous system diseases: central brain diseases, apoplexy, multiple sclerosis, spinal cord injury and peripheral neuropathy. (6) Intestinal smooth muscle or neurogenic lesions. (7) Colon neuromuscular diseases: pseudointestinal obstruction, Hirschsprung's disease, megarectum, etc. (8) Neuropsychological disorder. (9) Drug factors: iron, opioids, antidepressants, anti-Parkinson's drugs, calcium channel antagonists, diuretics and antihistamines. If there is no clear cause of constipation, it is called functional constipation (CFC). Among people with a secret history of defecation, functional constipation accounts for about 50%. 2. Functional Etiology The etiology of functional constipation is unclear, and its occurrence is related to many factors, including: (1) lack of food intake or lack of cellulose or water in food, which has little stimulation to colon movement. (2) Normal defecation habits are disturbed by intense work, too fast pace of life, changes in the nature and time of work, and mental factors. (3) Colonic dyskinesia, which is common in irritable bowel syndrome, is caused by spasm of colon and sigmoid colon. In addition to constipation, abdominal pain or bloating also occurs, and some patients may show constipation and diarrhea alternately. (4) The tension of abdominal muscles and pelvic floor muscles is insufficient, the driving force of defecation is insufficient, and fecal excretion is difficult. (5) Abuse of laxatives leads to drug dependence and constipation. (6) The elderly are weak, have too little activity, have difficulty defecating due to intestinal spasm, or have a long colon. Constipation is mainly divided into two types according to the pathogenesis: slow transit constipation and outlet obstructive constipation. Slow transit constipation is caused by the weakening of intestinal contraction, which slows down the movement of feces from cecum to rectum, or the uncoordinated movement of left colon. It is most common in young women and occurs around puberty. It shows that the frequency of defecation is reduced (the frequency of defecation per week is less than 1 time), the frequency of defecation is less, the feces are hard and it is difficult to defecate. There is no stool or hard stool during anorectal digital examination, but the external anal sphincter has normal anal contraction and forced defecation function; The total gastrointestinal or colonic transit time is prolonged; Lack of evidence of outlet obstruction, such as balloon exhaust test and normal anorectal manometry. Non-surgical treatments such as increasing dietary fiber intake and osmotic laxatives are ineffective. Diabetes, scleroderma complicated with constipation and constipation caused by drugs are mostly slow transmission type. Outlet obstructive constipation is due to the muscle disharmony of abdomen, anorectum and pelvic floor, which leads to the obstacle of fecal discharge. It is especially common in elderly patients, and many patients are ineffective in routine medical treatment. The outlet obstruction type can have the following manifestations: strenuous defecation, endless feeling or falling feeling, less defecation, defecation or insufficient defecation; There is a large amount of muddy feces in the rectum during anorectal examination, and the external anal sphincter may contract violently when defecating forcibly; The total gastrointestinal or colon transit time is normal, and most markers can remain in the rectum; Anorectal manometry showed that the external sphincter of anus contracted sharply or the sensory threshold of rectal wall was abnormal during forced defecation. Many patients with outlet obstructive constipation also have slow transit constipation. Life therapy 1. Analyze the causes of constipation and adjust lifestyle. Develop the habit of regular defecation; Quit smoking and drinking; Avoid drug abuse. You need to defecate in time when defecating, so as not to inhibit defecation. Repeated suppression of defecation for a long time can lead to the increase of defecation reflex threshold, the disappearance of defecation and constipation. 2. Advocate a balanced diet, increase dietary fiber and drink plenty of water. (1) High-fiber diet: Dietary fiber itself is not absorbed, but it can absorb water in the intestinal cavity, thus increasing fecal volume, stimulating colon and enhancing motivation. Foods rich in dietary fiber include wheat bran or brown rice, vegetables and fruits rich in pectin, such as mango and banana (note: immature fruits containing tannic acid will aggravate constipation). ? (2) Replenish water: drink plenty of water. It is suggested to drink more than 65,438+500 ml every day to keep enough water in the intestine, which is beneficial to the excretion of feces. (3) Adequate supply of B vitamins and folic acid: The use of foods rich in B vitamins can promote the secretion of digestive juice, maintain and promote intestinal peristalsis, and facilitate defecation. Such as coarse grains, yeast, beans and their products. Among vegetables, spinach and cabbage contain a lot of folic acid, which has a good laxative effect. (4) Increase gas-producing foods: eat more gas-producing foods to accelerate intestinal peristalsis and facilitate defecation; Such as onions, radishes and garlic sprouts. ? (5) Increase the supply of fat: appropriately increase high-fat foods, vegetable oil can directly moisten intestines, and decomposed fatty acids can stimulate intestinal peristalsis. Seeds of dried fruits (such as walnuts, pine nuts, various melon seeds, almonds, peach kernels, etc.). ) contains a lot of oil, which has the effect of moistening the intestines and relaxing the bowels. 3. Appropriate exercise is mainly medical gymnastics, which can be combined with walking, jogging and abdominal self-massage. (1) medical gymnastics: mainly to strengthen abdominal muscles and pelvic muscles. Practice method: Standing posture can do walking with legs lifted in place, squatting and standing up, abdominal back movement, kicking movement and turning movement. When lying on your back, you can lift one leg or both legs in turn at the same time, up to 40, and then put it down after a pause. Legs bend and stretch in turn, imitating riding. Lift your legs, draw circles from the inside out, and sit-ups. (2) brisk walking and jogging: it can promote intestinal peristalsis and help relieve constipation. (3) Deep and long abdominal breathing: When breathing, the diaphragm moves more than usual, which can promote gastrointestinal peristalsis. (4) Abdominal self-massage: Lie on your back in bed, bend your knees, rub your hands hot, put your left hand flat on your navel, put your right hand on the back of your left hand, and press clockwise with your navel as the center. Do it 2 ~ 3 times a day for 5 ~ 10 minutes each time.