Other complications:
Secrets often cause people's mood changes, upset and distracted, affecting their daily life and work, and are related to the occurrence and development of the following diseases.
Constipation can often lead to anorectal complications. Long-term constipation can cause carcinogens produced by intestinal bacteria fermentation to stimulate intestinal mucosal epithelial cells, leading to dysplasia and easy to induce cancer. Constipation causes perianal diseases such as proctitis, anal fissure, hemorrhoids, etc. Constipation, difficulty in defecation and dry feces can directly cause or aggravate anorectal diseases. Hard fecal blocks block the intestinal cavity, which narrows the intestinal cavity and oppresses the structures around the pelvic cavity, which hinders the peristalsis of the colon, compresses the rectum or colon and causes blood circulation disorder, and can also form fecal ulcers, which can cause intestinal perforation in severe cases. Colonic diverticulum, intestinal obstruction, gastrointestinal nerve dysfunction (such as loss of appetite, abdominal fullness, belching, bitter taste, excessive anal exhaust, etc.) can also occur. )
Constipation can also induce parenteral complications, such as stroke, brain function (memory loss, distraction, mental retardation), sexual life disorder, etc. It also plays an important role in the occurrence of hepatic encephalopathy, breast diseases, Alzheimer's disease and other diseases. Clinically, there is an increasing trend of cardiovascular diseases caused by constipation, such as angina pectoris and myocardial infarction.
Treatment principle of constipation:
1. Acute constipation is mostly caused by intestinal obstruction, so it is mainly treated according to the cause. If the patient has abdominal distension, dull pain and other symptoms, warm water enema can be used for treatment; If it is pathological obstruction, it should be treated by surgery in time.
2. If constipation is caused by diseases near anus and rectum, such as acute constipation caused by anal fissure, anal fistula, abscess around anus, huge internal hemorrhoid complicated with infection, we should actively treat these diseases, and at the same time take the method of softening stool or giving medicine from anus to facilitate stool discharge.
3. If acute constipation is caused by taking some drugs with constipation side effects, you should reduce or stop taking these drugs. If necessary, a laxative with little irritation to the intestine can be added.
4. Some chronic constipation caused by organic diseases should be treated after the cause is clear.
5. In case of constipation for a long time, even more than one year, or repeated intermittent constipation (or alternating episodes of constipation and diarrhea), patients who have no organic lesions in colon and rectum, are generally in good condition, have basically normal appetite, and have no emaciation, anemia and other manifestations can be considered as constipation with intestinal dyskinesia or irritable bowel syndrome. The treatment of this kind of constipation is generally difficult. You can try the following treatment measures.
(1) Encourage patients to do whatever exercise they can, such as playing Tai Ji Chuan, doing gymnastics, jogging or walking; Patients can be instructed to lie on the bed every night before going to bed and do abdominal exercise (deep abdominal breathing) for 15 ~ 3 min each time; Self-abdominal massage can be performed, and the massage method should be clockwise, from right to left, lasting for 15 ~ 3 min.
(2) Encourage patients to eat more vegetables rich in cellulose, bananas, pears, watermelons and other fruits, so as to increase the volume of stool, and drink more water and less strong stimulating drinks such as strong tea and coffee.
(3) Patients can be instructed to take honey orally frequently to relieve constipation.
(4) Patients should develop the habit of defecating regularly every day, so as to gradually restore or re-establish defecation reflex. Those who are busy in the morning or during the day can be scheduled at night (generally, it is better to schedule in the morning).
(5) Mosapride and other gastrointestinal motility agents can be selected to enhance intestinal motility and increase intestinal peristalsis, which has a good effect on slow transit constipation. Recently, it has been reported that tegaserod (trade name: ZeKyle) is a selective 5-HT4 receptor agonist, which can promote intestinal motility, shorten colon transit time and increase stool frequency.
(6) In principle, cathartics with strong irritation to the intestine should not be used in the choice of cathartics to avoid patients' dependence on drugs. At present, there are many kinds of cathartic agents to choose from, mainly including the following four categories.
① Volumetric cathartic: This kind of cathartic can increase the volume of feces to enhance the stimulation of feces on intestinal receptors. Commonly used cathartics are sodium carboxymethyl cellulose, lactulose, sorbitol, mannitol, polyethylene glycol 4(forlax) and salt cathartics (magnesium sulfate and sodium sulfate, etc.). Lactulose, polyethylene glycol 4, etc. are also called osmotic laxatives. After application, the osmotic pressure in the intestinal cavity can be increased, the water absorption can be reduced, and the fecal volume can be increased.
② lubricating laxatives: these laxatives are not absorbed in the intestine, but they can hinder the absorption of water, so they often play the role of lubricating the intestinal wall and softening feces (also known as feces softener). Liquid paraffin, glycerin and vegetable oil are commonly used. Because long-term application of this kind of laxative can lead to the absorption of vitamins A, D, K, calcium and phosphorus, it is not suitable for long-term use.
③ Irritant laxatives: some people also call it contact laxatives. These laxatives have a strong cathartic effect because they stimulate the intestinal mucosa and affect the absorption of water and electrolytes in the intestine. Plant laxatives such as rhubarb, senna leaf and aloe contain anthraquinone glycosides, which play a cathartic role only after being decomposed into anthraquinone by bacteria in the intestine. Long-term use of laxatives with strong irritation can cause patients' dependence on drugs. In addition, long-term use can also lead to melanosis coli. Because salt laxatives such as magnesium sulfate have strong stimulation on intestinal tract, they can also be classified in this category.
④ Local irritant laxatives: Glycerol/sodium chloride (Kaiselu) and glycerol suppository can make patients defecate and cause defecation reflex after being stuffed into the anus, which is called anal local laxatives and is better for patients with chronic outlet obstruction constipation.
In short, different cathartics should be used according to the constipation characteristics of patients (that is, individualized treatment), and in principle, cathartics with good curative effect, safety, long-term application tolerance and low price should be selected. However, it must be pointed out that for any constipation patient, we should not rely too much on cathartics, but should consider adjusting diet, avoiding fatigue, strengthening exercise and forming the habit of defecation at regular intervals as the main treatment means. People with psychological disorders should be treated accordingly.
(7) Biofeedback therapy can also be used if conditions permit, in order to increase the peristalsis function of intestine and facilitate the operation of feces.