Constipation (constipation) – delayed, difficult or systematically insufficient defecation (bowel emptying).
Constipation occurs as a result of slowing down the passage of fecal masses through the colon (cologne) or with difficulty in emptying the rectosigmoid part of the large intestine (proctogenic) due to a disorder in the coordinated work of the pelvic floor muscles and intestinal motility disorder. The main causes of development: violation of intestinal peristalsis, weakening of urge to defecate, the appearance of organic changes preventing the normal movement of the contents, a discrepancy between the capacity of the large intestine and the volume of contents.
For the duration of constipation distinguish acute (episodic – up to 12 weeks) and chronic (more than 12 weeks); etiopathogenetic: alimentary, neurogenic, reflex, hypodynamic, inflammatory, toxic, medicamentous, proctogenic, mechanical, endocrine, as a result of disturbance of the water-salt balance.
In patients with constipation, the clinical picture is quite similar: they complain of a decrease in appetite, increased fatigue, a taste distortion, a feeling of bursting in the abdomen, dull pain due to the accumulation of gases, empty desires for defecation, sometimes with the passage of scant feces without complete relief, the appearance complications from the anorectal zone, the development of secondary colitis, pathology of the biliary tract.
Treatment of constipation is complex. First of all, it is necessary to establish the cause of the violation of defecation, especially in acute processes. The purpose of laxatives is ancillary.
Laxatives are used in the treatment of episodic and chronic constipation in the elderly and with constipation with a decreased motor function of the intestine. Categorically contraindicated and ineffective laxatives in an intestinal obstruction (tumors, polyps, intussusception). The use of these drugs should be differentiated depending on the etiology and pathogenesis of constipation. Contact laxatives are more often used for hypo- and atonic constipation, in preparation for surgery or radiographic examination, proctogenic constipation.