Common causes of constipation are as follows
1. Develop bad defecation habits. 2-3 months is the best time to develop good defecation habits, and many parents miss this opportunity. The baby does not form a defecation reflex, even if there is defecation in the intestine, there is no defecation. The stool stays in the intestine for a long time, and the intestine absorbs the water in the light, and the stool becomes dry.
2. The diet is unbalanced and the dietary fiber is insufficient. Green vegetable water can be added for 2 months, banana puree can be added for 3 months, and vegetable puree can be added for 4 months. Many parents worry that the baby's stool will turn green, which will delay the addition of green vegetables, resulting in a serious shortage of dietary fiber in the baby's diet, and finally lead to constipation.
3. The diet spectrum is too thin, which is not conducive to the formation of stool. As emphasized in the previous article, rice flour is a transitional food. You must eat porridge for 6 months and replace rice flour with porridge as soon as possible. The reason is that the processing of rice flour is too fine, which is not conducive to the formation of stool and is easy to cause constipation. Eat less refined food and more coarse grains.
4. Intestinal flora imbalance, common in diarrhea or after using antibiotics. Intestinal flora imbalance is characterized by diarrhea, constipation or diarrhea constipation alternately. At this time, it is necessary to supplement intestinal probiotics, preferably with prebiotics. French Synbiotics is a good choice. There are other probiotics, such as Jin Bifeng, Mami Ai, Peifeikang and so on.
5. There is also intractable constipation, which is caused by the lack of nerves that control the peristalsis of intestinal smooth muscle. This is a congenital disease, which is very rare. This type of constipation is quite serious, drug treatment is completely ineffective, and surgery is needed.
1. General treatment: including diet, exercise and changing bad habits. For ordinary people without organic diseases, diet therapy is the first choice, that is, adding fiber foods such as bran, fruits and vegetables to their diet; Exercise is very helpful for ordinary people to defecate. Patients who stay in bed for a long time often have constipation and cause constipation. For some constipation patients, it is also very important to correct the tension in life, slow down the pace of work, and correct bad habits such as long-term humiliation.
2. medication: despite the above methods, many constipation patients still need laxatives to assist defecation. General constipation occasionally using laxatives will not cause adverse consequences, but long-term use of laxatives may produce dependence. Laxatives are generally divided into stimulating laxatives (such as rhubarb, senna leaf, phenolphthalein and castor oil), salt laxatives (such as magnesium sulfate), osmotic laxatives (such as mannitol), expansive laxatives (such as intestine moistening agents made of bran, konjac powder and agar) and lubricating laxatives (such as paraffin oil).
It is very important to choose laxatives according to the severity of constipation. Inflatable laxatives are suitable for chronic constipation, and irritating laxatives should be selected only when necessary, and should not be taken for a long time; Salt laxatives, stimulating laxatives and lubricating laxatives can be used for acute constipation, but the time should not exceed 1 week; For long-term chronic constipation, especially those who cause fecal impaction, enema can be used. Enemas are divided into salt water and soapy water, and salt water is less irritating than soapy water.
Cisapride is a new prokinetic drug for the treatment of colon constipation. Its mechanism is mainly to promote the release of acetylcholine from myenteric plexus, thus strengthening the movement of intestine and promoting the operation of small intestine and large intestine. After oral administration, it is absorbed quickly and thoroughly, reaching the peak of blood concentration within 1 ~ 2 hours, and the half-life is 10 hour. It can be used as an ideal drug for the treatment of colonic constipation. But for patients with severe constipation, it may take 2 ~ 3 months to achieve the ideal therapeutic effect.
3. Treatment of fecal impaction: enema, oral laxatives, enema and anal injection are usually ineffective. You can squeeze the perianal region by hand, and women can press the posterior wall of vagina with their fingers to help defecate. The commonly used method in clinic is to insert the index finger (wearing gloves) into the anus, divide the dry feces into small pieces, dig them out or stimulate them with kaisailu. If it fails, the fecal mass should be dug up under local anesthesia.
4. Hydrotherapy: This is an effective new therapy for intractable constipation. Sterilized and purified physiological saline is continuously injected into the anus through the instrument, and after repeated washing, the feces accumulated in the large intestine are discharged, so as to remove toxins, bacteria and parasites in the intestine and restore the normal absorption and excretion functions of the intestine. Different from oral laxatives and ordinary intestinal lavage, this therapy is painless and thorough, suitable for all kinds of constipation, and has the effect of detoxification and beauty. Generally every 1 ~ March1time, 45 minutes each time.
5. Biofeedback therapy: Biofeedback therapy is a therapy that enables patients to intuitively perceive the functional state of pelvic floor muscles during defecation, understand how to relax pelvic floor muscles during defecation, and increase intra-abdominal pressure to achieve defecation. Before treatment, it is necessary to explain the anatomy and physiology of pelvic floor to patients, and explain the methods and steps of this treatment to make them cooperate with the treatment. To master how to adjust defecation movements according to pressure changes and learn how to relax pelvic floor muscles requires repeated training and the establishment of conditioned reflex.
6. Surgical treatment: If constipation is still ineffective after conservative treatment for a period of time, some inspection methods can be used to see if there are organic lesions. That is, whether there is any surgical disease that needs surgical treatment. Surgical conditions of slow transit constipation: ① colonic weakness; ② No outlet obstruction; ③ Except for irritable bowel syndrome. Partial or subtotal colectomy can be performed. Outlet obstructive constipation: This disease can be diagnosed by defecography. Including: ① rectocele: it is solved by repairing the posterior vaginal wall or anterior rectal wall; ② Internal prolapse of rectum: Ligation of rectal mucosa is often used to shorten the length, or injection of sclerosing agent, surgical ligation and other comprehensive treatments; ③ Pelvic spasm syndrome (also known as pelvic floor achalasia syndrome): The surgical method of removing part of puborectalis muscle can be used, but the curative effect is uncertain.
(1) spastic constipation
1. Low-residue diet without crude fiber: First, eat a semi-liquid diet with low residue, fast vegetables and fruits, and then switch to soft food with low residue. 2. Appropriately increase fat < to moisten intestines, fatty acids promote intestinal peristalsis, which is beneficial to defecation; But not too much, it should be
3. Drink plenty of water: drink plenty of water and drinks, and keep the water in the intestinal feces to facilitate defecation, such as drinking honey water in the morning. 4. Eat foreign powder products: foreign powder absorbs water in the intestines, making the feces soft and smooth, which is conducive to excretion.
5. Fasting irritating food: It is forbidden to eat alcohol, strong tea, coffee, peppers, curry and other irritating foods.
(2) If obstructive constipation is caused by an organic disease, it should be treated first to remove the cause; Such as rectal cancer and colon cancer. If it is incomplete obstruction, clear fluid can be considered. Diet is limited to providing part of heat energy, food residues are at least controlled, and parenteral nutrition is the main way to provide heat energy. (3) impotence and constipation 1. Diets containing crude fiber: provide more foods containing crude fiber, stimulate the intestines, promote gastrointestinal peristalsis, and enhance defecation ability. Such as coarse grains, fruits with skins, fresh vegetables, etc. Polycellulose instant granules developed by Changhai Hospital taste good, 20g per package; Contains 7g of crude fiber, 1 ~ 2 packs of warm water, drink plenty of water every day. The clinical effect of treating constipation is satisfactory. 2. Drink plenty of water: drink plenty of water and drinks to keep enough water in the intestines, which is conducive to the discharge of feces. 3. Supplement B vitamins: Eating more foods rich in B vitamins can promote the secretion of digestive juice, maintain and promote intestinal peristalsis, and is conducive to defecation. Such as coarse grains, yeast, beans and their products. 4. Eat more gas-producing foods: eat more gas-producing foods to promote intestinal peristalsis and facilitate defecation; Such as onions, radishes and garlic sprouts. 5. High-fat: Appropriately increase high-fat foods, vegetable oil can directly moisten the intestines, and the decomposition product fatty acid can stimulate intestinal peristalsis. Such as peanut, sesame, walnut, peanut oil, sesame oil and soybean oil. Total fat can reach lOOg every day. Provide laxative food, such as foreign powder and its products, tremella soup, etc. 6. Dietary taboos: no drinking, smoking, spicy food, etc. Because these foods are not good for laxatives.