Constipation in adults: causes, treatment in Irkutsk at the Expert Clinic

Blessed is he who in the morning has a chair without compulsion,
To him food is to his liking, and all pleasures are available.

According to these lines, the authorship of which is attributed to Pushkin, one can indirectly judge that the problem of constipation was at least known already in the time of the great poet. Unfortunately, it does not lose its relevance today.

What to do for constipation: 7 causes and solutions

We talked about the problem of constipation in adults with the candidate of medical sciences, a gastroenterologist at the Expert Clinic, Irkutsk, Ayuna Khabinichnaya Mikhailova.

- Ayuna Khabinichna, in what cases can we talk about constipation in an adult? What it is?

Based on the definition, constipation is a syndrome (complex of symptoms), which is characterized by a violation of the secretory and evacuation function of the large intestine. It can manifest itself in the form of a rare stool (less than three times a week), characterized by a thickening of the consistency of feces, difficulty in defecation (a person pushes for a long time). In this case, there may be a feeling of an obstruction in the rectum, or it may be necessary to apply some special techniques to facilitate the passage of feces. If such manifestations persist for more than three months, they speak of chronic constipation.

Constipation is conditionally divided into functional and organic. With functional constipation, there is only a violation of the contractions of the intestinal wall and there is no organic pathology of the colon.

Why does constipation occur in adults? What are its reasons?

Among them:

a certain - in particular, "Western" - style of eating. It is characterized by a low content of plant fibers;
reduced amount of fluid taken by a person throughout the day;
irregular or changing diet;
elderly age. Such constipation is explained by age-related changes in intestinal contractility, weakness of the pelvic floor muscles, and some concomitant diseases;
sedentary lifestyle;
irritable bowel syndrome, one of the forms of which is characterized by the predominance of constipation;
pregnancy;
strictures (narrowing) of the colon;
colon cancer;
anal fissure, hemorrhoids;
Hirschsprung's disease;
parkinsonism;
multiple sclerosis;
systemic metabolic disorders - in particular, hypothyroidism, diabetes mellitus;
taking a number of medications (constipation as one of the side effects). These medications may include calcium channel blockers, iron supplements, antihistamines;
some mental illnesses (for example, depression).
I would like to make this point as well. It is very important to pay attention to the so-called "anxiety symptoms", a kind of "red flags": their appearance is a reason to immediately consult a doctor. Among them:

acute constipation, which arose suddenly, against the background of complete health and normal stools;
the appearance in the feces of blood, pus;
weight loss, fever, general weakness, loss of appetite.
- In children, there is such a thing as psychological constipation. Does this happen in adults?

If we talk specifically about the fear of defecation, as is observed in children, then in adult practice I have not encountered such a phenomenon. However, for example, a situation is possible when the act of defecation is difficult for a person due to the upcoming flight (lack of time) or during it; due to the lack of a toilet nearby, etc. In this regard, a person has to suppress the urge to defecate. That is, these are rather situations that can lead to constipation.   

How can you find the cause of constipation? What diagnostic methods are used for this?

First of all, you need to conduct a detailed survey of the patient, finding out the nature of nutrition, food intake, the amount of fluid you drink, all the characteristics of defecation (frequency, consistency of feces, the presence of pain during defecation, etc.), the presence of some other symptoms.

Then the doctor examines the patient (including the anorectal region), probes (palpates) the abdomen.

Colonoscopy

After that, depending on the doctor's assumptions, instrumental research methods are prescribed. Among them, the main method is colonoscopy, an X-ray examination of the intestine with barium. Special tests to examine bowel function may also be prescribed.

Learn more about the video colonoscopy procedure here .

What are the possible consequences of constipation in adults?

- First of all, this is a violation of the quality of life: the patient may develop a psychological dependence on the problem. Constipation prevents a person from living, working, developing.

Constipation increases the likelihood of anal fissures, hemorrhoids, diverticular disease, and colon cancer. With a long-term (a week or more) retention of feces in the large intestine and their absorption into the blood, intoxication (poisoning) by the products of the intestinal contents is possible. Ischemia (circulatory failure) in the colonic mucosa may develop, and mucosal cells may be damaged.

- What to do with constipation in an adult? How to fix a chair?

Treatment of constipation in adults is as follows. It is important to analyze the patient's lifestyle. First of all, you need to adjust the diet. You should eat at least 400 grams of vegetables and fruits per day. The amount of vegetable fiber (dietary fiber) as such should be at least 20-25 grams per day. Its source is, for example, and bran - they can be taken if, for some reason, vegetables and fruits are not available to a person. However, some bloating and abdominal pain can be a side effect of bran, so some people may refuse to take bran because of these symptoms.

No less important is the regularity of nutrition, with a mandatory, moderately high-calorie breakfast, not a late dinner.

The volume of daily drinking liquid is about 2 liters. It is useful to drink 1-2 glasses of water at room temperature in the morning. Drinks containing caffeine have some laxative effect.

You need to move enough. This is at least walking at least 3 times a week for 40 minutes. Movement increases intestinal peristalsis. Alternatively, you can work out on a treadmill and ride a bike.

It is important to try to develop a certain mode of bowel movement, that is, at a set time of day - a kind of automatism, a reflex. Even if at first there will be no act of defecation, over time it can improve and “attach” to time. It is also necessary to take into account the position of the patient during bowel movements - the so-called "eagle posture", when the knees are pulled up to the stomach, a low chair is under the feet.

Now about medical treatment. Laxatives are used. These are primarily means that increase the volume of intestinal contents. One example is lactulose-based drugs. It is a synthetic non-absorbable complex carbohydrate related to oligosaccharides. The plant used is psyllium. Another group is drugs that increase bowel contractions.

In order to eliminate constipation that appeared on the background of another disease, it is necessary to treat this disease.

It must be remembered that work with the large intestine is quite painstaking and relatively long.

- How to prevent the development of constipation in an adult?

Need to:

eat rationally. In this concept, I include not only a balanced diet for all the necessary substances, but also the regularity of food intake (at least 3 times a day). Fresh fruits and vegetables that can increase gas production are best eaten in the morning.
move. As an option - walking for 40 minutes 3 times a week. It's minimum. If for some reason this is not possible - for example, due to articular pathology - then in this case walking should be replaced with physical exercises individually selected by the doctor.
drink about 2 liters of fluid per day;
treat diseases that may cause constipation.