The common causes of constipation are as follows
I. The best time to develop good bowel habits is at the age of 2-3 months, and many parents miss out on this. The baby did not form a bowel reflex, even if there is stool in the intestinal tube, there is no intention of stool, the stool stays in the intestinal tube for a long time, the intestinal tube sucks up all the water in the stool, the stool becomes dry.
II. The diet is not balanced, the diet of edible fiber is insufficient. 2 months can start to add green vegetable water, 3 months can add banana puree, 4 months can add vegetable puree. Many parents are worried about the baby's stool green, delayed to add the time of the green vegetables, resulting in the baby's diet in the edible fiber is seriously insufficient, and finally lead to constipation.
Three. The dietary spectrum is too fine, not conducive to the formation of stools. The previous article emphasized the rice flour is a transition food, 6 months must begin to eat porridge, and as soon as possible to replace the rice flour with porridge, the reason is that the rice flour processing is too fine, is not conducive to the formation of stools, easy to trigger constipation. Eat less refined food, eat more rough food.
Four. Dysbiosis of intestinal flora, this situation is common in diarrhea or after the use of antibacterial agents. Intestinal flora dysbiosis is manifested in diarrhea, constipation or alternating diarrhea and constipation. At this time, it is necessary to supplement the intestinal probiotics, it is best to supplement with probiotics, the French synbiotic is a good choice. There are other probiotics, such as gold bifidus, mamma love, pepcid and so on.
V. There is another type of intractable constipation, caused by the absence of nerves innervating the peristalsis of the intestinal smooth muscle, is a congenital disease, less common. This type of constipation performance is quite serious, and drug treatment is completely ineffective, the need for surgical treatment
1. General treatment: including diet, exercise, change bad habits and other aspects. For the general people without organic lesions, dietary therapy is the first choice, that is, in the diet to increase fiber foods, such as bran, fruits, vegetables, etc.; exercise is very helpful for the regular defecation, long-term bedridden patients often have constipation caused by fecal incarceration; to correct the life of the tensions, slow down the pace of work and correct the long time to hold back the bowels of the bad habits, for some constipated people is also essential.
2. Medication: Despite the above methods, many constipated people also need to use laxatives to assist defecation. Occasional use of laxatives for general constipation will not cause adverse effects, but long-term use of laxatives may cause dependence. Laxatives are generally divided into irritant laxatives (such as rhubarb, senna, phenolphthalein, castor oil), salt laxatives (such as magnesium sulfate), osmotic laxatives (such as mannitol), swelling laxatives (such as gluten, konjac flour, agar to do the intestinal agent), lubricating laxatives (such as paraffin oil).
Targeted selection of laxatives according to the severity of constipation is very important. Chronic constipation to swelling laxative appropriate, only when necessary to choose stimulating laxative, never long-term use; acute constipation can choose salt laxative, stimulating laxative and lubricating laxative, but do not more than 1 week; long-term chronic constipation, especially those who cause fecal impaction, you can use the method of enema, enema solution divided into two kinds of saline and soapy water, and saline than soapy water irritation for the small.
Cisapride is a new type of pro-dynamic drug for the treatment of colonic constipation. Its mechanism of action is mainly to promote the release of acetylcholine in the intestinal interosseous plexus, which can enhance intestinal motility and promote the operation of the small intestine and large intestine. It is rapidly and completely absorbed after oral administration, reaching peak blood concentration within 1~2 hours, with a half-life of 10 hours. It can be used as an ideal drug for the treatment of colonic constipation. However, for those with severe constipation, it may take 2 to 3 months to achieve the desired therapeutic effect.
3. Treatment of fecal impaction: usually use enemas, oral laxatives, and corkscrew anal injection, often ineffective. Can be used to squeeze the perianal area, women can use the fingers to press the back wall of the vagina to help stool. The common clinical method is to insert the index finger (wearing gloves) into the anus, the dry fecal mass will be divided into small pieces, picking out or add corkscrew to stimulate the discharge, ineffective should be under local anesthesia will be dug out of the fecal mass.
4. Hydrotherapy: This is a new and effective treatment for stubborn constipation. Through the instrument, will be sterilized purified salt water constantly injected into the anus, after repeated rinsing, so that the accumulation of feces left in the colon discharged, to achieve the removal of intestinal toxins, bacteria and parasites, to restore the normal absorption and excretion of intestinal function of the purpose. Different from oral laxatives and common cleansing, the therapy is painless, thorough cleaning, suitable for all kinds of constipation, and has the effect of detoxification and skin care. Generally 1 time every 1 to 3 months, each 45 minutes.
5. Biofeedback therapy: Biofeedback therapy is a therapy that uses pressure measurement and electromyographic equipment to enable the patient to intuitively perceive the functional state of the pelvic floor muscles for defecation, and how to relax the pelvic floor muscles during defecation while increasing the intra-abdominal pressure to realize defecation. Before this treatment, the anatomy and physiology of the pelvic floor should be explained to the patient, and the method and steps of this treatment should be explained so that the patient will cooperate with the treatment. The patient should learn how to adjust the defecation movement according to the change of pressure and learn how to relax the pelvic floor muscles, which should be realized by establishing conditioned reflexes through repeated training.
6. Surgical treatment: constipation after a period of conservative treatment is still ineffective, through a number of means of examination to see whether there is an organic lesion. That is, whether there is a need for surgical treatment of surgical disorders. Slow transportation type constipation surgery conditions: ① colon without tension; ② no outlet obstruction; ③ except irritable bowel syndrome. Segmental or subtotal surgery of the colon can be done. Outlet obstruction constipation: this kind of disease can be diagnosed by performing fecal imaging. Including: ① anterior rectal protrusion: the use of repair of the posterior vaginal wall or the anterior rectal wall of the solution; ② rectal prolapse: the treatment is often used to shorten the length of ligation of rectal mucosa, can also be injected sclerosing agent plus surgical ligation of the combination therapy; ③ pelvic spasm syndrome (also known as the pelvic floor loss of flaccidity syndrome): can be used to resect a part of the puborectal muscle of the surgical method, but the efficacy of the uncertainty
(a) spasmodic constipation<
1. No crude fiber low residue diet: first eat low residue semi-liquid diet, forbidden vegetables and fruits, and then change to low residue soft food. 2. Appropriate increase in fat, fat laxative, fatty acids to promote intestinal peristalsis, is conducive to defecation; but should not be too much, it should be <LOOG / D is good.
3. Drink more water: drinking water and beverages, to maintain intestinal feces in the water, in order to facilitate laxity, such as drinking honey water in the morning. 4. Eat ocean powder products: ocean powder absorbs water in the intestinal tract and makes the feces soft and slippery, which is favorable for excretion.
5. Prohibit stimulating food: prohibit the consumption of wine, strong tea, coffee, chili, curry and other stimulating foods.
(2) Obstructive constipation If it is caused by organic pathology, the disease should be treated first to remove the cause of the disease; such as rectal cancer, colon cancer and so on. If it is incomplete obstruction, consider giving clear liquids. The diet is limited to providing partial calories and minimally controlling food residue, with extra-gastrointestinal nutrition as the main mode of supplying calories. (C) powerless constipation 1. Diet containing crude fiber: more supply of food containing crude fiber, stimulate the intestinal tract, promote gastrointestinal peristalsis, enhance defecation ability. Such as coarse grains, fruits with skin, fresh vegetables and so on. Changhai hospital developed multi-cellulose instant punch, taste good, 20g per package; containing crude fiber 7g, 1 ~ 2 packages per day warm water and drink more water, clinical use of constipation treatment effect is satisfactory. 2. Drink more water: drink more water and drinks, so that the intestinal tract to maintain sufficient water, favorable fecal discharge. 3. Supply B vitamins: consume more food rich in B vitamins, which can promote the secretion of digestive juices, maintain and promote intestinal peristalsis, which is conducive to defecation. Such as coarse grains, yeast, beans and their products. 4. Eat more gas-producing food: Eat more gas-producing food, promote intestinal peristalsis to speed up, is conducive to defecation; such as onions, radish, garlic and so on. 5. High-fat: appropriate increase in high-fat foods, vegetable oils can be directly laxative, and the decomposition products of fatty acids to stimulate intestinal peristalsis. Such as peanuts, sesame, walnuts and peanut oil, sesame oil, soybean oil, etc., the total amount of fat per day up to lOOg. supply laxative food, such as powder and its products, silver ear soup. 6. Dietary contraindications: avoid tobacco, alcohol, and spicy food, because these foods are not good for laxative.