Doctors will give individualized comprehensive treatment, including lifestyle adjustment, medication and surgery. Lifestyle modification mainly includes adjustment of dietary structure, establishment of correct defecation habits, and adjustment of mental state; medication includes laxatives, pro-dynamic drugs, pro-secretory drugs, enemas
drugs, suppositories and so on; and when the above methods are ineffective, and the symptoms have not been relieved, which seriously affects the patient's quality of life, surgical treatment can be chosen, but this method is relatively rare.
What are the general treatments for constipation?
Mainly refers to lifestyle modification.
Reasonable diet
Dietary fiber supplementation is the first choice of treatment for functional constipation, which can change the stool properties, promote intestinal peristalsis and thus easy to discharge. High-fiber fruits mainly include raspberries, pears, apples with skin, bananas, oranges and strawberries, etc.; fiber-rich vegetables such as peas, broccoli, turnips, potatoes and sweet corn.
Crude grains, such as bran, quinoa, oats, brown rice, and whole wheat bread, are also recommended. A daily intake of 25 to 35g of dietary fiber is recommended and should be increased slowly over several weeks, as a sudden intake of higher amounts may lead to bloating and belching.
Drink plenty of water
Drinking at least 1.5~2L of water per day can increase the water content in the feces, which makes the feces loose and easier to pass.
Exercise in moderation
Exercise can help increase the activity of the intestinal muscles, which is of even greater benefit to elderly patients who are bedridden and get little exercise.
Establishing good bowel habits
Do not inhibit the urge to have a bowel movement, and stay focused during bowel movements to minimize interference from external factors.
Keep your mood happy
Avoid stress in life and work.
What medications are available for constipation?
Because of individual differences, there is no absolute best, fastest, most effective medication, in addition to the commonly used over-the-counter medications, should be under the guidance of a doctor to fully integrate the individual situation to choose the most appropriate medication.
The medication for constipation in the general population.
Laxatives
Volumetric laxatives
By increasing the amount of water in the feces, the volume of feces is increased, making the feces loose and easy to pass, and are suitable for patients with mild constipation. These drugs are usually prescribed and are safe, with fewer adverse effects, and are often the first choice of treatment.
Common medications include polycarbophil calcium and wheat cellulose.
Osmotic laxatives
Adsorb water through the formation of a hypertonic state, increasing the volume of feces, suitable for patients with mild to moderate constipation. This class is usually prescribed, and common medications include polyethylene glycol
, lactulose
, and salt-based laxatives such as magnesium sulfate
.
Stimulant laxatives
stimulate intestinal secretion and enhance intestinal motility. This type of medicine is usually over-the-counter and works quickly, but long-term use can lead to dependence and cause the colon to turn black. Common drugs include bisacodyl
, senna
, anthraquinones, and castor oil
.
Lubricating laxatives
lubricate the intestinal wall and soften feces, and are indicated for elderly patients with comorbid chronic conditions
. This class of medications is over-the-counter, and common medications include cialis
and liquid paraffin.
Promotional medications
increase intestinal motility and are indicated for patients with slow-transmitting constipation.
This class of medications is prescribed, and common medications include mosapride
, itopride, and procarbazole, which acts selectively on the colon.
Microecological agents
These drugs contain probiotics, which are useful in relieving constipation and bloating, and can be used as an adjunctive therapy, and are generally over-the-counter.
Medication for constipation in special populations:
Elderly: volumetric and osmotic laxatives are preferred, and stimulant laxatives can be applied for a short period of time for severe constipation.
Pregnancy: lactulose and polyethylene glycol have a better safety profile, avoid stimulants such as anthraquinones and castor oil.
Children: corkscrew or saline enema, as well as wheat fiber, lactulose and polyethylene glycol are safe and effective.
What surgical treatments are available for constipation?
When the above treatments are ineffective, and the patient's symptoms seriously affect his or her work life, surgery can be considered, but it is important to note that surgery has a certain recurrence rate and may produce related complications.
Before the surgery, the severity of the anus and rectum abnormalities should be fully understood, and the surgery should be targeted.
Slow-transmission constipation
Total or subtotal colectomy, colonic absenteeism, or terminal ileostomy can be chosen.
Disordered defecation constipation
The options are anastomotic hemorrhoidal circumcision, transabdominal rectal suspension, transanal anastomotic proctocolectomy, transanal cavity cutting and stapling device proctocolectomy
with mucosal fixation, and conventional transrectal or vaginal proctocolectomy repair.
How is constipation treated with Chinese medicine?
The TCM treatments include medication and non-medication treatments.
Drug treatment will be identified by a TCM physician;
Non-drug treatment includes acupuncture and abdominal massage, the treatment area is 10cm around the umbilicus, the direction is clockwise, the power should be light and slow, once a day in the morning and once in the evening.
What other treatments are available for constipation?
Biofeedback therapy
Through medical equipment, patients can visualize the functional state of the pelvic floor muscles during defecation, and experience how to relax the pelvic floor muscles during defecation, which can improve the effect of constipation with pelvic floor muscle disorder.