Constipation patients, a few days without defecation, where did the stool go?
Constipation is a common and frequently-occurring disease that plagues many friends.
According to the textbook definition, chronic functional constipation refers to dry and hard stool, difficult or laborious defecation, less than three times a week, and the course of disease is more than half a year.
Constipation patients can't defecate for three or four days or even more than a week. Where are these stools?
How is stool produced?
Not all the food we eat can be digested and absorbed, and there are many components that cannot be absorbed, such as dietary fiber, which (mainly insoluble dietary fiber) will not be absorbed by the human body and eventually become one of the main components of stool.
In addition to dietary fiber and undigested food residues, the main components of feces are water, bacteria and mucosal cells shed from the intestine.
The digestion and absorption of food is mainly in the small intestine. After the food you eat passes through the small intestine, the remaining unabsorbable components, as well as water and some electrolytes enter the large intestine. When food residues enter the large intestine, they are still in liquid state and contain a lot of water.
The main function of the large intestine is to absorb water and electrolytes. After the water is absorbed, the food residue gradually turns into feces in shapes and strips.
With the peristalsis of the large intestine, the formed stool produced by our body will move from the colon to the rectum and be stored in the rectum. When the stool reaches a certain amount, it will trigger the defecation reflex. We go to the toilet to excrete feces.
Why constipation?
Here we mainly discuss two reasons of constipation from the physiological mechanism:
? Slow movement of large intestine
The feces in the large intestine always stay in the large intestine. Under normal circumstances, it may take a day from the large intestine to the rectum. Constipation patients have slow colon movement, and it may take a long time to reach the rectum, which may take two days, three days or even longer.
This condition is called slow transit constipation. Patients with slow transit constipation may not defecate for a long time and have no feeling of defecation for a long time.
? Abnormal defecation reflex.
Feces are stored in the rectum, and the large intestine will trigger the receptors in the rectum and upload the feeling of defecation to the brain.
Under normal circumstances, the brain will issue instructions, the anal sphincter, pelvic floor muscles and rectal muscles will cooperate, and the rectal muscles will exert their strength to push the stool out of the rectum. The anal sphincter relaxes and excretes feces.
If the defecation reflex is abnormal and the defecation muscle movement is uncoordinated, it can lead to difficulty in defecation. This condition is called outlet obstructive constipation.
Constipation patients, where did the stool go?
Constipation patients, for several days without defecation, actually didn't go anywhere, has been in the large intestine.
The feces in the large intestine stay in the large intestine for a long time, which leads to excessive water absorption, and the stool becomes more and more dry and becomes hard stool. Some patients have stools like sheep dung balls, one by one.
If you want to defecate, you must defecate as soon as possible. If you hold the stool, causing the water inside to be absorbed, the stool will become dry, with too little water and insufficient lubrication, which may lead to difficulty in defecation.
In the long run, a vicious circle will be formed, defecation will become more and more difficult, and constipation will be formed.
Therefore, constipation patients, the stool is still in the large intestine, and they haven't gone anywhere, but the water has been absorbed, and the stool is getting drier and drier, making it more and more difficult to defecate.
How should constipation be treated?
? Changes in eating habits
Drink plenty of water, the amount of water per day is more than 2000 ml, and the increase of water can increase the moisture in the stool. "Wet" stool has less friction resistance and is easier to defecate.
Eat more fruits and vegetables, coarse grains and other foods rich in dietary fiber. Dietary fiber (mainly soluble dietary fiber) can absorb a lot of water, promote intestinal peristalsis and help defecation.
? Develop a good habit of defecation
Develop the good habit of defecating regularly every day, don't hold your stool, and hurry to defecate when you defecate. Don't play with your mobile phone, read the newspaper, don't be distracted, concentrate on defecation, and develop the good habit of defecation regularly every day.
? medicine
Many drugs can promote defecation, but some drugs can cause dependence or damage patients' intestines. So don't take medicine indiscriminately, and be sure to find a regular doctor to prescribe medicine.
? biofeedback therapy
For constipation patients with abnormal defecation reflex and outlet obstruction, biofeedback therapy can be used to stimulate pelvic floor muscles and form normal defecation reflex.
? Surgical therapy
Severe constipation, constipation that is ineffective in conservative treatment, can be treated surgically with the consent of the patient. There are many surgical methods, such as total colectomy and partial colectomy, and the surgical methods need to be decided according to the patient's situation.
In short, constipation patients who haven't defecated for several days have been in the intestines, but the water has been absorbed, which makes defecation more and more difficult.
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This article was reviewed by Wei Wei, Master of Gastroenterology, Qilu Hospital affiliated to Shandong University.
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