Prolonged constipation and supportive measures

This is an automatically translated article.

Article written by Doctor Vu Duy Chinh - Vinmec Times City International General Hospital
Constipation is a relatively common symptom. To be able to overcome the uncomfortable problems caused by prolonged constipation as well as avoid unwanted complications, we need to understand the timely and appropriate treatment methods.

1. What is considered prolonged constipation?

Constipation can be defined as decreased frequency of bowel movements, pain, difficulty passing stools, incomplete bowel movements, or small or hard stools. Of these symptoms, the frequency of bowel movements is the easiest to identify. In medicine, constipation is usually defined as less than three bowel movements per week.
However, constipation is also identified in people who pass several times a day, but have small or hard stools.
Researchers often use the Rome III criteria to define constipation. Patients with constipation must include two or more of the following:
Difficulty defecating in at least 1/4 of the times. Small, lumpy, or hard stools on at least one-quarter of the bowel movements. Feeling of incomplete urination for at least one-quarter of the time you go to the bathroom. Feeling of anal obstruction during at least one-quarter of bowel movements. Use hands or medical intervention for at least one-quarter of trips to the bathroom. Less than three bowel movements per week. If constipation persists, worsening condition without treatment will easily lead to hemorrhoids or dangerous diseases related to the digestive tract.
Elderly people, people with unhealthy lifestyle, eating habits or often sitting for too long will be more easily constipated than usual.

2. Manifestations of prolonged constipation

Manifestations of chronic, persistent constipation often include:
Constipation for more than 12 weeks/year prior, although this may be intermittent. The most obvious manifestation is the frequency of bowel movements less than 3 times/week and decreases depending on the severity of constipation. Each bowel movement is very difficult, must push a lot and especially have to exercise the abdominal muscles and diaphragm a lot. This condition lasts for a period of several months to several years (in people with chronic constipation). Solid dung, lumpy lumps like goat dung. Even every time you go out, you must have outside support. There may be fresh blood in the stool before or after the stool due to excessive straining, which leads to the anal mucosa being scratched. In addition to blood, stools may contain mucus. Constipation for a long time will lead to continuous damage to the anus, easily leading to internal hemorrhoids, external hemorrhoids or other rectal diseases that are difficult to treat. Abdominal pain with many different degrees, there are cases of severe abdominal pain, accompanied by gas, bloating. You always have the feeling that you have to influence from the outside to make it easier to defecate. Therefore, you will often rub your belly or gently press your abdomen every time you have a bowel movement. To be able to accurately detect the symptoms of prolonged constipation, each of us needs to pay attention to the frequency of bowel movements as well as the characteristics of stools and other abnormalities, from which there are treatments. appropriate and effective.

3. Causes of prolonged constipation

3.1. The cause lies outside the digestive system

Endocrine causes: Due to the influence of endocrine diseases such as diabetes, hypothyroidism, hyperthyroidism cause constipation, long-term constipation leads to prolonged constipation.
Neurological causes: Diseases and nerve damage are also one of the causes of constipation such as: Constipation after spinal cord injury, cerebrovascular accident, Parkinson's,... Diet and activities: Improper diet, too much or too little fiber can all lead to constipation. In addition, not drinking the necessary amount of water or eating foods that are easy to cause constipation such as unripe guava, sapodilla, ... are also factors that cause constipation. Systemic causes: Constipation when high fever persists or prolonged lying motionless. Causes of electrolyte disorders: Electrolytes play an extremely important role in regulating body activities. Disorders of electrolytes are also a cause of constipation,... Other common causes: Effects when using certain drugs such as laxatives, drugs that coat the stomach lining, iron drugs, ... Habit of sitting a lot or being exposed to toxic chemicals, typically lead. The psychological habit of being afraid to go outside, often holding back from going out, also leads to a change in the body's bowel habits and causes constipation.

3.2. The cause lies outside the digestive system and abdominal cavity

Constipation caused by this group of causes is often caused by diseases related to the digestive tract, especially colon diseases: congenital megacolon, unexplained colon enlargement, chronic inflammatory bowel diseases, disorders of the colon. Colon dystonia, long colon, colon polyps, rectal mucosal prolapse,...

4. How to cure prolonged constipation

Answering the question of what causes long-term constipation is difficult, finding a cure for this condition is not simple. This article will give you some methods to make persistent constipation will no longer be a concern.

4.1. Changing lifestyle and living habits

First of all, when treating long-term constipation, it is necessary to change lifestyle and living habits so that the digestive tract works as smoothly and stably as possible. This simple job brings a noticeable effect, but it requires your efforts:
Maintain healthy eating habits: Eat enough meals, have enough quality, eat on time, do not do other things while eating . Eat foods that are good for the functioning of the digestive system including all kinds of fresh vegetables and fruits. Especially in which: Fruits: Raspberry, kiwi, apple, banana, grape, apricot,... Vegetables: Green leafy vegetables such as kale, spinach,... Root vegetables: Sweet potato , carrots,... Eat raw foods, whole grains, bread, brown rice, noodles, lentils. Eat a lot of yogurt: Yogurt contains probiotic bacteria - a type of good, healthy bacteria that lives in the digestive tract. This bacteria helps food to be digested quickly and enhances the activity of the digestive system.

Avoid foods that cause constipation: White bread and corn foods are very constipated. These foods should be limited. Drink enough water every day: Drinking enough water is an extremely good habit and gives you countless health benefits. Remember to drink enough water every day, at least drink 1.5 liters -2 liters of water or more. Avoid certain beverages and stimulants: Diuretic beverages such as tea, coffee, coca, and alcohol can cause dehydration of the body, making constipation worse. Physical activity: Active exercise and regular physical activity help prevent constipation very well. Choose sports suitable for your physical condition and interests, do not sit for too long in one place but get up to exercise for a healthy and supple body. Practice regular bowel habits Don't be afraid to have a bowel movement or hold back when you show signs of wanting to go to the toilet to lead to prolonged constipation. Try to go to the bathroom in the morning or about 30 minutes after a meal, as this is an easy time to go to the bathroom. Using the shower, turn on warm water with little pressure to flush the anus (this works to soften stools and relieve pain in the anus). When going to the toilet, you should keep your mind relaxed, avoid stress and sit for too long. Do not try to push if you feel the stool is solid, can't be pushed out, if you push, it can tear the anal mucosa, causing blood in the stool, anorectal pain,... Correct sitting posture when going to the toilet: There are 2 main ways to go to the toilet: squatting and sitting on the floor. The squatting position is the best toilet sitting position, because when in this position, the anal canal will be in a straight position, so that the stools are pushed out more easily and naturally, and you don't have to exert much effort. to push stool out. If you sit on the floor, you should put a chair about 20cm high at your feet to raise your legs, folding your thighs into your stomach will make it easier to go to the toilet.

4.2 Treatment of constipation according to the cause

When lifestyle changes and living habits do not help constipation improve, you need to see a doctor to find out the cause, from which the doctor will prescribe appropriate treatment for each type of cause and cause. degree of disease. Using drugs to treat constipation requires a doctor's prescription, do not use drugs indiscriminately or arbitrarily, it will not be effective, and it will cost more.

5. Use laxatives to cure constipation

5.1. Do not arbitrarily use laxatives without the consent of your doctor

The use of laxatives to treat constipation can cause dependence on the drug, the drug relieves constipation but also makes the patient not feel like going to the toilet for many days, stopping the drug can make the condition of constipation. fertilizer return. Use laxatives only when dietary and lifestyle changes fail. When taking laxatives to treat constipation, drink plenty of water. This helps to increase the effectiveness of the medicine while avoiding dehydration that makes constipation worse.

5.2. Types of laxatives

5.2.1. Mechanical laxative

This is a group of drugs that are considered safe by acting only locally, including some drugs such as: Cellulose (methylcellulose), gomme sterculia, hemicellulose, agar-agar,... Features of this group of drugs are: Soluble in water, not absorbed in the intestine. They help absorb water into the stool mass, soften stools and increase stool volume. The drug will take effect after 1-3 days, from the time of taking it.
Note when using:
Mechanical laxatives can interfere with the absorption of some substances. Due to its slow duration of action, the drug is used only for the prevention and treatment of chronic constipation. The drug can cause bloating and gas in some people.

5.2.2. Osmotic laxative

Is a drug that contains substances that are not absorbed, retain water in the intestine and cause irritation to the toilet. The length of time the drug takes effect depends on the active ingredient and the form.

5.2.3. Lubricant laxative

Ingredients: Mineral Oil.

5.2.4. Stimulating laxative

This group of drugs increases peristalsis in the small intestine and large intestine, stimulates muscle contraction to eliminate waste, and takes effect after 6-12 hours of taking the drug.

Currently, Vinmec Times City International General Hospital is applying a treatment method for cases of constipation due to a decrease or loss of defecation reflex by anal electrical stimulation combined with interference waves, biofeedback episodes. study (Biofeedback). The above method has helped > 80% of patients to recover the defecation reflex, improve bowel motility and the process of defecation, helping to improve constipation.
Depending on the patient's constipation, the doctor will appoint necessary investigations such as: colonoscopy with contrast, anorectal pressure measurement, assessment of bowel function and pathologies. related to the pelvic floor... to find the cause, thereby giving the optimal treatment regimen. Hundreds of patients of different ages have achieved the desired treatment results. The most important criterion to evaluate the success of treatment is that the patient has a regular daily bowel movement, easier bowel movements,...

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