Constipation - infrequent stools, which happens at least once every 3 days. Constipation also include hard stools; discharge of a small quantity of feces (less than 100 g); a feeling of incomplete bowel evacuation after defecation; prolonged the act of defecation, for the implementation of which requires additional bearing-down efforts or the use of special techniques and postures.
Diagnostics
Diagnosis of constipation is primarily based on a thorough questioning and of itself does not pose significant difficulties. Much more difficult is to establish the cause and mechanisms of development of constipation, since they determine the choice of treatment.
If stool frequency changes are stored for weeks or occur intermittently, and with increasing frequency and severity, should be suspected tumor of the colon or other causes of partial blockage of the lumen intestine.
Please be aware that the cause of constipation can be one or another pathology actual rectum and anus.
In the diagnosis of constipation may need x-rays of the abdomen and the colon or endoscopic examination of the colon (
colonoscopy, sigmoidoscopy).Only after eliminating all the possible causes of organic disease should think about the presence of the most common causes of chronic constipation - irritable bowel syndrome and functional constipation.
constipation treatment
The choice of treatment for chronic constipation is defined causes and mechanisms underlying their development.
It should be noted that the normal urge to defecate occurs, usually in the morning, usually after breakfast. In this regard, the so-called conventional functional constipation should be regularly in the same time go to the toilet after breakfast, trying to gradually achieve a bowel movement.
Meals should be regular, at least 4 times a day. It is important in this case sufficient of at least 1.5 liters per day fluid intake, comprising not only tea, coffee and soups, juices, mineral water, dairy products (kefir, yogurt). Particular attention should be given to foods rich in herbal dietary fiber - vegetables, fruits, berries, bread from wheat flour, bran, porridges, and also products containing organic acids and sugars, which also increased the percentage in vegetables, fruits, berries, juices and dried fruits.
Read more about food for constipation - in our a separate article
Only if all possibilities of treatment of chronic constipation without the use of laxatives drugs and eliminated heavy organic bowel disease, we can recommend laxatives drugs.
Classification laxatives
Modern classification laxatives means includes 4 groups, which are distinguished according to the mechanism Action, action at various levels of the digestive tract and therefore have a different time of onset of laxative effect.
Group 1.
Chemical laxatives (surfactants) causing laxative effect by stimulation of chemical receptor system and colon thus stimulating its contraction.
These drugs act on the level of the colon and generally cause a single defecation after 6-10 hours after administration. For drugs in this group include senna preparations, buckthorn, rhubarb, bisacodyl, Guttalaks, dulkolaks, castor oil.
Group 2.
Laxatives having the ability to retain water in the intestinal lumen, leading to an increase in volume and softening of stools. For drugs of this group include the sodium and magnesium sulfate, citrate, magnesium hydroxide, Carlsbad salt, lactulose (Duphalac). They act on the level of the colon, and the onset of a laxative effect is 8-12 hours.
Group 3.
Bulk laxatives or fillers that contribute to increase the volume of the intestinal contents, such as bran, agar-agar, methylcellulose, etc. and seaweed.
Group 4.
Laxatives oil promoting softening of hard stools and facilitate their sliding: liquid paraffin, almond oil, fennel oil. They act on the intestinal level, so laxative effect after administration occurs after 4-5 hours.
Laxatives are produced in various forms: for oral administration in the form of tablets, powder, capsules, drops, solutions, syrups, slurries, as well as suppositories and solutions for enemas, which act directly on the mucosal contact line intestine.
Long-term chronic administration of laxatives is accompanied by a high risk of undesirable side effects. May develop addiction to drugs and the need for communication with the receiving increasing doses of drugs.
For example, at the level of self-chronic administration of one of the most popular among patients laxatives, drugs Senna, there is a pronounced dose-dependent effect: over time, there is a need 8-10-fold increase in daily dose the drug.
Uncontrolled laxatives, which is now common, especially among women wishing to lose weight may lead to the development of an organism dehydration liver and kidneys.
Most efficient for constipation, if enriched diet, a change in the nature and eating habits are insufficient, prescribe lactulose (Duphalac et al.).
Dufalac adult is administered in the form of powder for oral administration at a dose of 10-30 grams per day in the first 2 days. Then move to a maintenance dose of 10-20 grams per day. Children 1-6 years of initial and maintenance doses are the same and about 3-7 g / day. (Preferably in the form of a syrup). Children up to 1 year to designate syrup at a dose of 3 g / day.
The drug is used 1 time per day in the morning during a meal. With properly selected dose effect occurs within 2 days of admission.
