Incomplete bowel movement: causes, symptoms and treatment. False urge to defecate. What is the normal emptying frequency? Appointed in case of ineffectiveness of the above measures

Often people are faced with such a problem as false urge to defecate. If such a phenomenon is rare, the problem is associated with malnutrition and a violation of the water balance in the body. However, if false urges to the toilet occur constantly, you need to think about getting a thorough diagnosis from a specialist. Nevertheless, not everyone is in a hurry to discuss such troubles with other people, even with a doctor. As a result, a person receives a correct diagnosis already at the stage when the disease reaches serious proportions and it takes a long time to treat it.

Therefore, do not ignore any violations in the body. This is especially true of the systematic repetition of unpleasant symptoms. It is possible that they will pass into a more significant form, and the disease will become chronic.

1 Etiology of the problem

A similar phenomenon is due to the fact that the intestinal muscles begin to contract convulsively, while the reasons may be different. All this is accompanied by very unpleasant sensations in the abdomen and it may seem that the intestines should be emptied. However, nothing happens while visiting the toilet. The absence of feces with the urge to defecate is a suspicious symptom that requires careful study and determination of the cause.

Often, such a nuisance leads to malnutrition or food poisoning. For example, if the food is poorly processed, it causes a certain discomfort in the intestines, which leads to the urge to go to the toilet. The same happens with the use of expired and toxic products. They provoke indigestion, which leads to various troubles. False urges will be only the most harmless of them.

Most often, the problem disappears after taking absorbents and completely cleansing the intestines of toxins. If the urge occurs too often and this phenomenon does not stop for a long period, one can suspect the pathology of the gastrointestinal tract. A similar symptom is characterized by gastritis, ulcers, pancreatitis and many other diseases that can occur in a chronic form.

A false urge to defecate during antibiotic treatment is considered a common occurrence. If you take medications incorrectly, there may be a side effect such as intestinal dysbacteriosis. This problem often leads to abdominal pain, false toilet urges, and heartburn.

If the symptom does not go away for a long time and the process of defecation itself becomes difficult, you should definitely consult a doctor. It is possible that in this case we are talking about serious pathologies of the gastrointestinal tract, including oncology. Getting rid of trouble is a must. This is necessary not only because of constant discomfort, but also because of possible complications. For example, false urges are often accompanied by constipation, and this is a sure way to hemorrhoids. In this case, the patient will experience not only discomfort during a visit to the toilet, but also blood discharge along with feces. Treatment of hemorrhoids is a difficult and long business, so you should try to prevent the development of such a pathology.

No need to overload your body. For example, false bowel movements are more common in people who are actively involved in sports, especially cycling. In rare cases, such a nuisance is faced by people who, when emptying their intestines, have a large amount of feces. But in such a situation, the problem goes away quickly.

2 Associated symptoms

False bowel movements, medically known as tenesmus, are often accompanied by many other symptoms that can help identify the underlying disease. Pain is the most important symptom of a problem. She always accompanies, and the symptom itself can drag on for a long time.

Most often, with false urges, feces do not come out of the rectum. However, even if a small amount of feces does appear, most likely they will be accompanied by blood. This is due to the strong tension in the anus, on which cracks appear.

In addition, with a false urge to defecate, such troubles as feeling sick, vomiting, and even fever can occur. Similar symptoms are characteristic of poisoning and intoxication, so effective measures must be taken urgently.

Frequent additional symptoms that accompany tenesmus are constipation and diarrhea. This is not only unpleasant, but also dangerous, so you need to see a doctor and undergo a diagnosis in order to get the most correct and high-quality treatment.

3 How to get rid of false urges?

If a person has such a nuisance as constant urge to go to the toilet, in which there is no bowel movement, it is imperative to figure out what are the reasons for what is happening. To do this, you need to visit a doctor and tell the specialist about everything that worries. If the problem is left unattended, it can turn into complications, such as hemorrhoids and cracks in the anus.

Treatment of false urge to defecate is divided into 2 types. In the first case, the main work is carried out on the elimination of the symptom itself, and in the second, the causes of the problem are treated. Only a doctor after a thorough examination can determine which medicine will be more successful in a given situation. You should not self-medicate, since even prolonged intoxication can actually turn out to be a very serious illness, for example, a tumor.

To get rid of the false urge to defecate, experts always recommend a special diet. It should be designed in such a way as to eliminate either constipation or diarrhea. Be sure to give up products that are harmful to the stomach and intestines and irritate the digestive tract. It is best to include in your daily menu dishes that are easily absorbed by the body. The diet must include fresh vegetables and fruits. Do not forget about the drinking regime. The stool often depends on it.

If you have problems with defecation, you must strictly limit physical activity. It is especially not recommended to spend a lot of time cycling, riding horses and driving a car for a long time. Swimming and walking have a positive effect on the body. In addition, you can perform simple morning exercises, which will be enough for the normal maintenance of the body.

As for drug treatment, antispasmodics, such as No-Shpa and Papaverine, are most often prescribed here. But you can use them only with the approval of a doctor, since such drugs have contraindications and side effects.

For the treatment of diarrhea and intoxication, absorbents are used, such as white and activated carbon, Polysorb.

There are many useful folk methods that help get rid of the false urge to defecate. For example, a decoction of watermelon peels works well. It is also worth including milk with bran in your diet. Goat's milk is best for treating stool problems.

But you should not completely rely on traditional medicine. In the event of such a nuisance as false urge to empty the intestines, it is necessary to consult a doctor.

For citation: Shulpekova Yu.O., Ivashkin V.T. Pathogenesis and treatment of constipation // BC. 2004. No. 1. S. 49

Constipation is a syndrome that characterizes a violation of the process of bowel movement (defecation): an increase in the intervals between acts of defecation compared to the individual physiological norm or a systematic insufficient bowel movement.

Constipation should also be considered a difficulty in the act of defecation (while maintaining the normal frequency of stools).
The prevalence of constipation among the adult population of highly developed countries is, on average, 10% (up to 50% in England). The widespread occurrence of this disorder gave reason to classify constipation as a disease of civilization.
The normal frequency of stool is an indicator that is individual for each person. It is generally accepted that in practically healthy people the normal frequency of stools ranges from 3 times a day (about 6% of those examined) to 1 time in 3 days (5-7% of those examined). Typically, these features are hereditary.
Constipation can be temporary (episodic) or long-term (chronic, lasting more than 6 months).
There are standard diagnostic criteria for chronic constipation:
. straining, occupying at least 25% of the time of defecation;
. dense (in the form of lumps) consistency of feces;
. feeling of incomplete bowel movement;
. two or less bowel movements per week.
To establish a diagnosis, it is enough to register at least 2 of these signs during the last 3 months.
Stool retention is often accompanied by unpleasant subjective sensations, such as lethargy, headache, insomnia, decreased mood, decreased appetite, nausea, unpleasant taste in the mouth; discomfort, feeling of heaviness or fullness in the abdominal cavity, bloating, spastic abdominal pain. For a significant part of patients suffering from chronic constipation, the characteristic features of the psychological appearance are "care for the disease", suspiciousness.
At the heart of the development of constipation, 3 main pathogenetic mechanisms can be distinguished, occurring in isolation or in combination:
1) increased absorption of water in the colon;
2) delayed transit of feces through the large intestine;
3) the inability of the patient to perform an act of defecation.
Comparison of pathogenetic mechanisms with the "functional units" of the colon in some cases allows you to localize the affected segment of the colon. Thus, the formation of dense fragmented feces is characteristic of a violation of the propulsive peristalsis of the colon, in which the most intensive absorption of water occurs. The absence of the patient's urge to defecate indicates a violation of the sensitivity of the receptor apparatus of the anorectal segment, which performs the function of accumulation and evacuation of feces.
The reason for the development of temporary constipation is usually a change in living conditions and the nature of food, the presence of unusual and uncomfortable conditions for defecation (the so-called "travelers' constipation"). Emotional stress is capable of provoking a temporary violation of the stool. In addition, temporary constipation is often observed in pregnant women, due to natural physiological changes.
In a hospital, the reason for the violation of adequate emptying of the colon can be prolonged bed rest, taking various medications, the use of barium sulfate in x-ray studies with contrast. In some situations, when straining is especially harmful to the patient (in the acute period of myocardial infarction, in the early period after surgical interventions on the abdominal organs), the prevention and treatment of constipation becomes especially important.
Temporary retention of stool is far from in all cases should be considered as a sign of any pathological condition. However, the occurrence of constipation in a middle-aged or elderly patient should first of all cause oncological alertness.
According to J.E. Lannard-Jones identifies the following types of chronic constipation:
1) associated with lifestyle;
2) related to the impact of external factors;
3) associated with endocrine and metabolic disorders;
4) associated with neurological factors;
5) associated with psychogenic factors;
6) associated with gastroenterological diseases;
7) associated with the pathology of the anorectal zone.
Table 1 lists the most common diseases and conditions associated with chronic constipation.
Nutrition plays an important role in the regulation of intestinal motility. Long-term use of mechanically sparing, high-calorie, low-volume food, the absence of foods containing coarse fiber or dietary fiber in the diet contribute to constipation. There are products that have a fixing effect. These are strong coffee and tea, cocoa, cottage cheese, rice, pomegranates, pears, quince, astringent products, chocolate, flour. Improper diet and lack of physical activity are the main cause of constipation among the population of developed countries.
If we do not take into account the cases of constipation associated with the peculiarities of lifestyle, then, according to E.K. Hammad, G.A. Grigoryeva, among the causes of chronic constipation in the age group up to 20 years, the anatomical features of the large intestine dominate; at the age of 20-40 years - pathology of the ano-rectal zone; after 40 years - psychogenic, neurogenic, endocrine, gastroenterological causes of constipation and causes associated with the pathology of the anorectal zone are equally common.
Constipation is a very characteristic symptom of such endocrine diseases as hypothyroidism, hyperparathyroidism. Thyroid hormone deficiency and hypercalcemia are accompanied by intestinal hypotension.
The timing of the onset of constipation in diabetic patients depends on the severity of the course of the disease.
In recent years, the pathogenesis of functional constipation within the framework of irritable bowel syndrome has been intensively studied. Violation of the emptying of the colon in functional constipation is associated with a change in the peristaltic activity of the intestinal wall. Constipation is spastic in nature, when the tone of some part of the intestine is increased and the feces cannot overcome this place. The stool takes on the appearance of a "sheep". Hypotonic or atonic functional constipation is associated with a loss of tone in the colon. In this case, the delay in defecation can reach 5-7 days, the feces can be large in volume, loose in consistency. Diagnosis of irritable bowel syndrome requires a thorough examination to rule out other possible causes of constipation.
Painful defecation (with thrombosis of external hemorrhoids, anal fissures) acts as an additional factor predisposing to stool retention.
Many drugs cause constipation when overdosed or as a side effect. Narcotic analgesics, anticholinergics, some antihypertensive drugs inhibit the peristaltic activity of the intestine, affecting its nervous regulation. Aluminum-containing antacids, iron preparations also cause constipation.
Systemic diseases accompanied by damage to the vessels and nerves of the intestine (diabetes mellitus, scleroderma, myopathies) form a picture of chronic intestinal obstruction - the syndrome of intestinal pseudo-obstruction.
Examination of a patient with impaired bowel syndrome should include a thorough questioning and examination of the patient, assessment of lifestyle, collection of a "drug" anamnesis, digital examination "per rectum", a study of general and biochemical blood tests, coprograms. The data obtained determine the algorithm for further examination. Identification of symptoms of "anxiety" (asthenic manifestations, fever, weight loss, anemia, increased ESR, the presence of blood in the feces) makes it necessary to conduct an endoscopic / x-ray examination of the intestine.
The main principle of constipation treatment should be etiotropic therapy, elimination of the cause leading to impaired bowel function.
As mentioned above, very often the only reason for the disruption of the normal peristaltic activity of the intestine in residents of developed countries is the lack of dietary fiber in the diet, as well as a decrease in motor activity. In this regard, the first step in the treatment of constipation should be measures aimed at maintaining a healthy lifestyle. The basic principles of non-drug correction of bowel function include:
1) Eating foods high in dietary fiber. Indigestible dietary fiber contributes to water retention, increases the volume of stool and makes it soft, which contributes to the establishment of peristalsis. It is recommended to eat raw vegetables, fruits, gourds, sea kale, stone fruits, bananas, fermented milk products, crumbly cereals, wholemeal bread, vegetable oil. It is advisable to reduce the consumption of foods that have a fixing effect (cottage cheese, tea, coffee, cocoa, rice, chocolate, flour). The medical industry produces nutritional supplements containing natural or synthetic dietary fiber: food bran, Psyllium, Metamucil, etc.;
2) regular meals (breakfast is especially important);
3) sufficient fluid intake (preferably up to 2 liters per day);
4) adhere to the rule of regular bowel movements. The activity of the colon increases after waking up and after eating, so that urges are observed mainly after breakfast. The urge to defecate should not be ignored, as this may result in a decrease in the threshold of excitability of rectal receptors;
5) daily physical activity. It helps to increase the peristaltic activity of the intestine.
In the absence or insufficient effectiveness of etiotropic therapy and non-drug methods for restoring stools, symptomatic therapy for constipation is resorted to. For this purpose, drugs are used that increase the peristaltic activity of the intestine artificially - laxatives.
Table 2 presents the modern classification of drugs used in the treatment of constipation, proposed by D.A. Kharkevich (1999) .
The classification of laxatives can be based on the mechanism and localization of their action (Tables 3 and 4).
With occasional constipation, it is possible to use magnesium-containing drugs (magnesium oxide - 3-5 g per night, magnesium sulfate - 2-3 tablespoons of a 20-25% solution per night), Guttalax (10-20 drops per night), suppositories with glycerin. In addition, you can resort to setting warm water enemas of small volume (250 ml).
With prolonged (over 6-12 months) taking laxatives, psychological dependence can develop and, along with this, the phenomenon of addiction.
In this regard, the constant and daily intake of laxatives can be recommended only for special groups of patients - for example, oncological patients receiving high doses of narcotic analgesics.
An overdose of laxatives is accompanied by the development of diarrhea and, as a result, dehydration and electrolyte disturbances (potassium and magnesium deficiency). The appointment of laxatives in combination with diuretics, glucocorticoids, cardiac glycosides requires special care due to the high risk of electrolyte imbalance. The most common overdose symptoms are observed when taking saline laxatives; the use of drugs of this class requires an individually selected dosage.
Taking laxatives is contraindicated in acute inflammatory diseases of the abdominal organs, acute intestinal obstruction, with severe dehydration and hypersensitivity to drugs.
It is necessary to dwell separately on the characterization of the negative aspects of preparations containing anthraglycosides (drugs of rhubarb, senna and buckthorn), which are especially widely used by patients in self-medication. Herbal origin, availability and ease of use are deceptive positive aspects of these drugs.
It has been shown that with long-term use of drugs containing anthraglycosides, their metabolites accumulate in the intestinal mucosa, macrophages of the mucosal lamina propria, and ganglion plexus neurons. At the same time, atrophy of the mucous and muscular layers of the intestinal wall develops, as well as a violation of autonomic innervation. Degenerative changes in smooth muscles and nerve plexuses over time can lead to severe inhibition of peristalsis, up to atony. Such changes are called "laxative colon". Decrease in peristaltic activity, decrease or absence of haustration, areas of spastic contractions are determined radiographically.
Based on his experiments, Westendorf J. suggests that one of the mechanisms of action of laxatives containing anthraglycosides - an increase in the water content in feces - is associated with a violation of the integrity of the mucous membrane due to the cytotoxic effect of anthraglycoside metabolites. In some patients, with prolonged use of these drugs, inflammatory changes in the intestines are found, similar to ulcerative colitis.
In addition, complications from the procto-anal section were noted: the development of cracks and lacunae of the anal canal (with a frequency of 11-25%), cicatricial stenosis of the anus (with a frequency of 31%), thrombosis and prolapse of hemorrhoids (with a frequency of 7-12 %) .
After at least a year of use of laxatives containing anthraglycosides, patients develop a reversible phenomenon of pseudomelanosis of the colon - a black staining of the mucous membrane, probably due to the accumulation of anthraglycoside metabolites in macrophages of the lamina propria. Colon pseudomelanosis does not appear to be a precancerous condition. However, in a study by Siegers C.P. et al. it has been shown that in patients taking laxatives containing anthraglycosides for a long time, the risk of developing colorectal cancer is three times higher than in the general population. At the same time, the presence of chronic constipation itself is not associated with an increased risk of developing a malignant tumor of the colon.
In experiments on rats, it was shown that the metabolites of antraglycosides - anthraquinones - have a mutagenic potential. Anthraquinones catalyze oxidative reactions, which result in the formation of semiquinone and oxygen radicals that damage the cell genome.
Metabolites of antraglycosides - anthranoids - have potential hepatotoxicity. The possible role of anthraquinones in the development of degenerative-inflammatory changes in the kidneys is discussed.
Anthraquinones cross the placenta and into breast milk. At present, the mutagenic / carcinogenic effects of anthraquinones on the body of the fetus and infant cannot be ruled out in principle.
Recently, drugs that stimulate nerve endings in the colon mucosa, which is accompanied by an increase in peristaltic activity, have become increasingly popular in the treatment of episodic and chronic constipation. The representative of this group is Guttalax (sodium picosulfate) of the German pharmaceutical company Boehringer Ingelheim. This drug is a "prodrug". Sodium picosulfate is converted to the active form of diphenol in the lumen of the colon by the action of bacterial enzymes - sulfatases.
The mechanism of action of Guttalax is the stimulation of the receptors of the colon mucosa, which is accompanied by an increase in peristaltic activity.
Guttalax is practically not absorbed from the gastrointestinal tract and is not metabolized in the liver. The laxative effect, as a rule, develops 6-12 hours after taking the drug.
Guttalax is available in the form of a solution (7.5 mg / ml) in plastic dropper bottles, which allows the patient to accurately select the required amount of solution (based on the individual response to laxatives) and avoid overdose. The usual dose for adults and children over 10 years of age is 10-20 drops (with persistent and severe constipation - up to 30 drops); for children 4-10 years old - 5-10 drops. It is advisable to take the drug at night. The mild action of Guttalax provides the expected effect by morning.
It should also be borne in mind that when prescribing antibiotics, the laxative effect of Guttalax may decrease.
The most typical situations in which the use of this drug is optimal are constipation in patients on bed rest, temporary constipation associated with a change in the nature of food, emotional stress and uncomfortable conditions for defecation ("travelers' constipation"), painful defecation due to pathological processes in the area anus (fissures, hemorrhoids). Guttalax is effective in eliminating constipation in cancer patients receiving high doses of opioids (used at a dose of 2.5-15 mg / day).
Reports on clinical trials of the drug (including placebo-controlled) reported its good tolerability in all age groups; side effects were observed rarely - no more than 10% of patients and consisted in the appearance of mild flatulence or abdominal pain immediately before defecation. There was no addiction to the drug.
Guttalax, if necessary, after consultation with an obstetrician-gynecologist, can be prescribed to pregnant women (effective at a dose of 2-10 mg / day). As a result of the study (128 patients), chronic inflammatory diseases of the genital tract significantly prevailed in pregnant women with functional constipation compared with pregnant women with gestational constipation and pregnant women without constipation. The appointment of the laxative Guttalax led to the normalization of the content of the intestinal and genital microflora, as well as intestinal permeability and a decrease in the development of various complications during pregnancy, childbirth and the postpartum period. Guttalax did not have a negative effect on the fetus and no effect on the contractile activity of the uterus. The drug does not penetrate into breast milk, however, if necessary, its use during lactation, breastfeeding should be discontinued.
Successful treatment of constipation lies in establishing the causes and choosing the right treatment program. Timely treatment of constipation is a reliable prevention of the pathology of the upstream sections of the gastrointestinal tract and other body systems.

The normal frequency of bowel movements is from 1-2 times a day to once every 2-3 days. However, for various reasons, these figures change. Diarrhea and constipation become deviations from this norm. With some types of constipation, there is no urge to defecate, this is characteristic, in particular, of atonic types of constipation.

Why is there no urge to defecate?

The child does not have the urge to defecate

In a child, the causes of constipation, most often, are problems with the intestines and the digestive system that is not yet fully developed. In most cases, such results are caused by malnutrition of young children or nursing mothers. Formula-fed babies may suffer from constipation caused by improper dilution of the formula, too abrupt change of it, lack of water in the body. Also, the causes of problems with the stool can be incorrect or untimely introduction of certain products into the diet.

Often, constipation occurs in children during teething, in the treatment of various diseases using antibiotics, taking Aquadetrim or iron preparations.

Symptoms of constipation in a child, characterized by the absence of the urge to defecate, are: bloating, pain and discomfort in the abdomen, poor appetite, and so on. The temperature in such cases, as a rule, remains within the normal range.

Why there is no urge to defecate in an adult

The reasons that adults do not have the urge to defecate can be the following factors:

• improper nutrition. This reason is the most common. Often constipation occurs with insufficient food, lack of water in the body or a diet with a predominance of fatty foods and a lack of plant fibers;
• ignoring the urge to defecate;
• violations of the normal hormonal background. With pathologies of the thyroid gland, diabetes mellitus and other hormonal problems, constipation may develop;
• abuse of laxatives. If a person takes such drugs for a long time, his independent defecation may be disturbed, which leads to constipation;
• pathologies of the nervous or digestive systems;
• mechanical obstructions in the intestines. They can be tumors, adhesions or scars;
• taking certain medications: painkillers, iron supplements, tranquilizers and other medications.

No urge to defecate after childbirth

Postpartum constipation is often associated with reduced bowel movements, muscle weakness after pregnancy and childbirth, a sedentary lifestyle, and tears and stitches that occur during childbirth. In addition, psychological reasons for the development of such a condition are also possible. Signs of this condition are: abdominal cramps, lack of defecation and urge to defecate, irritability, sleep problems, symptoms of intoxication, headaches, and so on.

In such cases, it is worth consulting a doctor to determine the factors that led to the development of constipation, and choose a treatment that will help to cope with them.

No urge to defecate due to nerves

Constipation often occurs on a nervous basis. This may be due to the inability to change the current unpleasant situation, subconscious fear, stress and other similar reasons. Psychological constipation can occur in both adults and children. It can be quite difficult to get rid of them, since the elimination of external manifestations does not lead to a complete correction of the situation, and problems with defecation recur after a while. To combat such a problem, you should try to eliminate stress and unpleasant situations, eat right, drink enough water and maintain physical activity.

No urge to defecate, what to do?

If there is no urge to defecate, but there are symptoms of intoxication, then you should seek medical help. An emergency measure of help in such situations is gastric lavage using Esmarch's mug. At home, such a procedure is quite difficult to carry out, so you can make a simple enema with an increased volume of water. It is desirable to add a small amount of castor oil, which has a laxative effect, to the liquid. After solving the problem with the stool, preventive measures should be taken to prevent the recurrence of such a situation. If constipation occurs again, you should consult a doctor.

No urge to defecate: treatment

The treatment of constipation involves several important points:

1. Proper nutrition. The diet in such cases is not too strict. It implies the presence in the daily menu of fresh fruits and vegetables, cereals, except for rice, dairy products. Fatty, smoked and fried foods are excluded from the diet.
2. If the urge to defecate is absent for a long time, you need to pay attention to other symptoms. Such manifestations as abdominal pain, severe bloating, weakness, pallor of the skin and mucous membranes are considered dangerous. In such cases, immediate medical attention is required.
3. The reason for the lack of urge may be a lack of liver enzymes. In such cases, patients are prescribed choleretic drugs.
4. Local laxatives may also be given, such as

Good afternoon! It does not really matter at what age there is constipation, since they are most often of a functional nature. Restoring bowel function is not an easy process. One of the causes of constipation is an unhealthy diet. In this case, it is necessary to follow all the recommendations, and in this case the situation can be changed for the better. It is necessary to constantly engage in physical education - this is one of the main recommendations. You can't give up exercise. Another important recommendation to follow is proper nutrition. It is necessary to analyze your daily diet, and, if necessary, correct it. You need to know that for the stable functioning of the intestines, about 30–35 g of fiber is needed every day. Foods such as cereals, fruits and vegetables contain a sufficient amount of fiber. It is required to make a diet so that as much fiber as possible is included in each meal, but not more than normal. To do this, the Internet will help you, everything is explained in detail in the tables. You also need to know that fiber is well absorbed with the right level of fluid in the body. Increase the amount of fiber in your diet gradually. At the initial stage of treatment, in addition to a gradual increase in the level of fiber in the diet, for the occurrence of rhythmic urge to defecate, a laxative course is used for up to one month. Talk to your doctor about the use of any drug from this group. Drinking regime should be plentiful. The amount of liquid consumed per day should be at least 350 ml per 10 kg of body weight. At the initial stage, refrain from using spicy marinades, spices, and alcoholic beverages in your diet. Organize your daily meal in such a way that meals with a lot of fiber are combined with other meals. Remember to alternate plant-based foods with foods that contain proteins and carbohydrates. To constantly support the defecation reflex, it is necessary to drink a glass of cool water on an empty stomach before breakfast. These recommendations will be effective at the entire stage of treatment, the effect will not come very quickly if the rectal reflexes fail due to an unbalanced diet that was before. I would recommend that you make an appointment with your doctor so that in the future you can clarify the course of treatment and diet. If all of the above fails, then it is necessary to continue to investigate the causes that disrupt the functioning of the intestine. Full therapy should be under the guidance of a proctologist.

The time required for complete digestion of food, starting from the moment it enters the esophagus and ending with the act of defecation, is normally no more than 72 hours. If this period is more than three days, and defecation is difficult and accompanied by pain, then this condition is called constipation. Every second woman has such problems, and for men this figure doubles (in one in four).

Problems with stools in the form of constipation can occur at any age, from the first day of life to the most advanced years. Depending on why there were difficulties with timely emptying of the intestines, they can be divided into:

1. Habitual, associated with lifestyle, the body's reaction to unusual conditions, nervous disorders.
2. Functional in violation of the intestines.
3. Caused by diseases of the gastrointestinal tract, anatomical abnormalities of the body.

Why does constipation begin and what to do?

Any violation of the process of formation of fecal masses and their movement can lead to problems with the stool. The main causes of constipation are:

1. Disorder of muscle activity.
2. Lack of urge to empty the bowels.
3. Pathological changes in the organs of the gastrointestinal tract, which do not allow the normal movement of the contents entering the intestine.
4. An altered ratio of the volume of intestinal contents and the capacity of the large intestine, which does not correspond to the normal process.

To determine what causes constipation, it is necessary to understand exactly how the process of formation of fecal masses occurs before they are brought out. Mixing of the incoming liquid contents occurs in the initial section of the large intestine. At the same time, water and nutrients are absorbed into the circulatory system. The middle section serves to accumulate, form and remove feces. The essential role of the rectum in defecation is that the feces, entering the intestine, stretch it and, irritated mucosal receptors, push the feces out.

The vertical position that a person takes when getting out of bed causes pressure of fecal masses on the lower sensitive parts of the rectum and provokes the urge to defecate. The absence, despite the fact that the patient continues to consume food, leads to the accumulation of feces, which, being absorbed into the bloodstream and circulating throughout the body, cause poisoning. Accumulating in the connective tissues, fecal slags weaken the immune system. At the same time, the load on the kidneys, heart, liver, lungs, and skin begins to increase significantly, creating tension in their work.

The most common reason why constipation occurs is nutritional (alimentary) factors. Monotonous, predominantly flour or meat food, a small amount of it, violations of the diet leads to constipation. Violation of intestinal peristalsis contributes to an insufficient amount of liquid, dry food, hard, poor-quality water. Why constipation begins in a person can be explained by a violation of the coordination of various types of motor skills, when spasms occur in one place, and atony develops in another. With violations of intestinal motility, its motor activity, and primarily in the sigmoid colon, becomes unproductive. Constant inhibition of the movement of feces along it provokes a delay in stool. At the same time, slowing down the transit of feces contributes to additional absorption of water, leading to compaction of feces, a decrease in its volume.

A decrease in motor activity leads to an atonic type of stool retention, and a convulsive contraction of the intestinal walls leads to spastic constipation. Depresses gastric motility depression, depletion of nerve receptors caused by the partial consumption of laxatives or enemas, conscious suppression of the urge to defecate when a person is in an unsanitary environment or is embarrassed by publicity. Reduced volumes of feces, due to malnutrition, lack of the required number of chemical pathogens, also affects the weakening of motor skills.

Why do atonic constipations appear? This may be due to severe infectious diseases, severe exhaustion, lack of physical activity, and they are also characteristic of older people, women who have given birth a lot. Why does a person have spastic constipation? There is a wide variety of answers to this question. The reasons may be:

1. The beginning of inflammatory processes or the development of ulcers in the gastrointestinal tract.
2. The reaction of the diseased organ of the abdominal cavity and, first of all, the genitourinary system.
3. Reflex fear of pain during bowel movements, in the presence of cracks, hemorrhoids, ulcers or scars in the rectum.

In case of violations of the endocrine glands, menopause, failures occur in their work, which explains why constipation begins. Occupational poisoning by substances while working with them, poisoning with nicotine or narcotic substances, as well as eating food containing a large amount of tannic astringents, which causes constipation, is also noted in a large number of people. Among the reasons why constipation occurs are diseases of the reproductive system in women and men, as well as the presence of diseases such as cholecystitis, nephrolithiasis, and the like.

To eliminate the reflex retention of the stool, it is very important to establish the source of this reflection. At the same time, diseases of the nervous system, such as cerebrovascular accidents, infectious diseases caused by viruses or chronic progressive diseases of the nervous system, quite often serve as a source of constipation. Sometimes difficulties with defecation begin in people who lead an active lifestyle and consume enough fiber.

The explanation of why and what causes constipation in adults, in this case, may lie in the use of certain drugs, primarily diuretics, painkillers, as well as medications for the treatment of diseases of the cardiovascular system. Problems with difficulty emptying the bowels can cause antidepressants, narcotic and psychotropic drugs, drugs that are taken to normalize the acidity in the stomach.

From what constipation in pregnant women is explained by hormonal changes in the body leading to a decrease in intestinal activity. In addition, the growing volume of the uterus puts its weight on the intestines, destabilizing its work and causing delays in stool. Emphysema, obesity, heart failure lead to weakness of the muscles of the diaphragm and abdominal wall, which increases intra-abdominal pressure during bowel movements.

Why do constipation still occur?

The answers to the question of why constipation is formed are very diverse, starting with muscle weakness of nervous tension and ending with violations of the usual defecation stereotype, the so-called tourist syndrome. What causes constipation in an adult and why stool retention in a child, the reasons can vary significantly. For example, why does constipation occur in an adult? The most likely reasons may be:

1. Increased tone of the muscle sphincters, abdominal hernia or weakened muscles of the pelvic floor or abdominal wall.
2. Irritable bowel syndrome, conscious suppression of the urge to defecate.
3. Mental illnesses leading to malfunction of the intestines.

Why do adults still get constipation? A special group of causes are stool disorders associated with medication. The most common drugs, the use of which increases the risk of difficult defecation can be called:

• containing calcium carbonate, aluminum hydroxide;
• antispasmodics;
• anti-inflammatory nonsteroidal drugs;
• antidepressants;
• codeine, morphine and derivatives of these drugs;
• remedies for ulcers;
• drugs for the treatment of epilepsy;
• antibiotics, as well as antiadrenergic drugs and antihypertensives;
• anti-tuberculosis drugs.

Therefore, when using certain drugs from these groups, you should carefully study the instructions. This is especially true for those who have a predisposition to the development of functional stool retention. Having found out why constipation occurs, you can begin treatment. If the cause of problems with timely bowel movements is food, then it is necessary to change the diet. The fact is that with improper nutrition, the main place in the diet is occupied by starchy foods with a low content of vitamins and minerals. Mixed with protein foods, such food leaves a kind of scale in the diverticula of the large intestine, which is gradually converted into fecal stones.

Increasing the diet of foods high in fiber, eating them raw, rough, as well as freshly squeezed juices, cold carbonated drinks, will help stabilize the situation. Why is it desirable to strictly dose medication for constipation? This is necessary so as not to provoke a further weakening of the intestinal muscle tone. If the abdominal muscles are weakened in the elderly or as a result of bed rest, special physical exercises and lifestyle changes to a more active one, including increasing the time spent in the fresh air, are recommended.

At the onset of psychogenic constipation, it is necessary to eliminate provoking factors and conduct symptomatic therapy. If stool retention is a secondary symptom, then the underlying disease is treated first. In any case, self-medication is allowed only in case of errors in nutrition, and in all others it is necessary to consult a doctor. The doctor will determine why and what causes constipation, and prescribe a qualified treatment.

Normally, the urge to defecate (emptying the intestines) occurs when the ampoule (end part) of the rectum is filled. Each person has their own bowel release biorhythm. The normal frequency of bowel movements is varied - from 3 times a week to 2 times a day. Constipation is usually called difficult or systematically incomplete bowel movement, or the absence of such for 3 days or more.

The signs of constipation are:

• an increase in the intervals between acts of defecation compared with the individual physiological "norm";
• forced straining;
• intermittent or persistent insufficient bowel movements, feeling of "incomplete emptying of the bowel";
• discharge of a small amount of feces of increased density (subject to good nutrition).

Constipation affects more than 20% of the population, and during pregnancy and after it, the risk of occurrence increases significantly. This problem has not only physiological, but also psychological aspects. Specialists know that seemingly innocuous difficulties with the evacuation of the contents of the intestine from the body often become the source of many problems.

A bit of physiology

What helps a person to empty the intestines on time? It has been established that the act of defecation depends on the following factors:

• Intestinal microflora. It is based on protective microbes, represented by the so-called bifidobacteria and lactobacilli, which form a protective biofilm on the surface of the mucous membrane, as well as E. coli. The normal amount of protective microflora ensures the breakdown of proteins, fats, carbohydrates, nucleic acids, regulates the absorption of water and nutrients, as well as the motor activity of the gastrointestinal tract.
• Motor (motor activity of the gastrointestinal tract. It is thanks to this function that the contents of the intestine normally move along the gastrointestinal tract without delay.

According to the mechanism of occurrence, two types of defecation disorders can be distinguished.

First type- atonic in which the tone of the muscular wall of the intestine decreases. Peristalsis becomes sluggish, unproductive. Atonic constipation often occurs due to muscle weakness, after a caesarean section. This is a common bowel reaction to any surgical intervention in the abdominal cavity. It can also occur due to dietary errors.

Atonic constipation may be accompanied by pulling, aching pains in the abdomen, a feeling of fullness in the intestines, increased gas formation, lack of appetite, nausea, lethargy, apathy, depressed mood. When defecation occurs, there is a lot of fecal masses, the initial portion is formed, dense, of a larger diameter than normal, the final portion is liquidish. Defecation is painful, there may be tears of the mucous membrane of the rectum and anus, then streaks of blood and (or) mucus remain on the surface of the feces.

Second type - spastic constipation, when the tone of the intestine is increased and peristalsis becomes unproductive due to the "squeezed" state of the intestine. For this type, psychological reasons are more characteristic.

In the spastic form, the pain is paroxysmal, more often in the left side of the abdomen. There may be flatulence (rumbling in the abdomen), lack of appetite, fatigue, nervousness, irritability, nausea, stool in the form of the so-called "sheep feces" - the stool is very dense in small rounded portions. The urge to defecate may even occur several times a day, but the emptying of the intestines is incomplete, difficult, in small portions.

Constipation in the postpartum period is associated, as a rule, with several reasons:

1. Changes in hormonal levels. During pregnancy, hormones that soften the ligaments also have a relaxing effect on the muscles of the intestine, as a result of which it becomes more difficult for it to get rid of its contents.
2. Weakening and stretching of the abdominal and perineal muscles. Stretched abdominal muscles during pregnancy do not adequately support the intestines and viscera.
3. Change in the position of the intestine in the abdominal cavity, its gradual displacement to its usual place.
4. Violation of peristalsis - the motor activity of the intestine, due to which food masses move.
5. Fear of straining due to the presence of sutures (imposed in the case of caesarean section, sutures in the perineum) and hemorrhoids.
6. Irrational diet for a nursing mother.
7. Psychological stress associated with caring for a child and a new family status.
8. Congenital anomalies of the intestine, for example, its elongated sections.

Separately, it should be said about taking various medications. For the prevention and treatment of anemia (hemoglobin deficiency), preparations containing iron are prescribed, which to some extent contribute to constipation. Aggravates constipation and the use of antispasmodic drugs (such as NO-SHPA). Constipation can also be the result of taking pain medications that are prescribed in the postpartum period to relieve postoperative stitches or painful postpartum contractions.

The diagnosis is established by the doctor on the basis of general examination data, the history of the development of the disease and the results of bacteriological examination of feces.

Solution

Treatment of constipation should be carried out strictly individually, after a thorough examination and under the supervision of a physician.

Diet. To solve the problem of constipation, a young mother, in any case, needs to choose the right diet, taking into account breastfeeding and possible allergic reactions.

To eliminate dysbacteriosis, foods containing essential oils rich in cholesterol, as well as fat breakdown products formed during frying, and foods that cause fermentation in the intestines, should be completely excluded from the diet. Food is steamed or boiled.

An approximate daily diet should be at least 100 g of protein, 90-100 g of fat, 400 g of carbohydrates. 6-8 g of table salt, 100 mg. ascorbic acid, 0.8 g calcium, 0.5 g magnesium, 30 mg. nicotinic acid.

• Rye or wheat bread from wholemeal flour, bran yesterday's baking.
• Soups on weak meat, vegetable broth with pearl barley.
• Meat, poultry, fish of low-fat varieties boiled and baked in one piece.
• Cereals in the form of crumbly cereals and casseroles from buckwheat, wheat, millet, barley groats.
• Vegetables - beets, carrots, lettuce, cucumbers, zucchini, pumpkin, possibly a small amount of tomatoes.
• Fresh vegetable salads, vinaigrettes.
• Dried fruits (dried apricots, prunes) soaked

Useful muesli, buckwheat, millet and pearl barley, oat bran, black bread, vegetable oils, vegetables and fruits, fresh and cooked. For example, carrots, beets, squash, spinach, lettuce, broccoli, cabbage, dried fruit compotes, melon, apples, apricots, cherries and dairy products.

You can take a decoction of gooseberries (pour a tablespoon of berries with a glass of water and boil for 10 minutes, then strain). Take it in a quarter cup 4 times a day, if necessary - you can add sugar. When brewing tea, you can add slices of dried apples or cherries. In the atonic form of constipation, the bowels are stimulated by a glass of cool water, drunk in the morning on an empty stomach.

With constipation, you can not use strong tea, mucous soups, semolina, white bread, wheat bran, polished rice, blueberries, quince, pears, currants, strawberries. Hard cheeses can also slow down peristalsis.

If dysbacteriosis is detected, the doctor may prescribe you drugs containing bifido- and lactobacilli.

Laxatives.

When breastfeeding, taking laxatives - FORLAX AND FORTRANS is not contraindicated.

Of the ready-made laxatives during breastfeeding, you can not take: GUTALAX, REGULAX, CHITOSAN-EVALAR, DULKOLAX (BI-SACODIL), DOCTOR THAISS - SWEDISH BITTER.

Senna-based preparations (SENNALAX, GLAXENNA, TRISASEN) increase the tone of the muscular wall of the intestine, so they should not be taken with spastic forms of constipation. When breastfeeding, they must be taken very carefully, as they can cause colicky pain in the baby.

Attention! With frequent and prolonged (several times a week for 1-2 months) use of almost any laxatives (both medicinal and herbal), addiction may develop, requiring an increase in the dose of the laxative. The effect of its use is weakening, and the problem of constipation itself is aggravated .

Phytotherapy. To solve the problems of constipation, herbal medicine offers salad recipes that will help improve bowel function. For example: fresh carrots, lingonberries, figs, dried apricots, greens. Or: fresh beets, carrots, prunes, raisins, greens. The amount of ingredients depends on your taste; a good dressing for all salads is vegetable (preferably olive) oil.

Fresh (one percent) kefir, curdled milk, fermented baked milk have a laxative effect. You can drink a glass of cold water with a spoonful of sugar in the morning or eat a banana, a couple of apples.

No less effective for the treatment of constipation and infusion of prunes with figs. It is prepared as follows: 10 berries of prunes and figs are washed and poured with a glass of boiling water, covered with a lid and kept until morning. The liquid is drunk on an empty stomach; 5 berries of prunes and figs are eaten at breakfast, the rest - in the evening. Here are some more recipes.

With spastic forms:

• Freshly prepared potato juice, diluted in water 1:1, take a quarter cup half an hour before meals 2-3 times a day.
• A decoction of figs in milk or water at the rate of 2 tablespoons of raw materials per 1 cup of boiling water; you need to let it cool at room temperature and take 1 tablespoon 2-4 times a day.
• Mix in equal parts the fruits of anise, stinging nettle herb, valerian rhizome officinalis, wild strawberry leaves, chamomile flowers, peppermint leaves. Brew a tablespoon of the collection with a glass of boiling water in a thermos and leave for 1.5 hours, then strain. Take half a glass after meals in the morning and evening.

With atonic forms:

• Mix in equal parts the fruits of anise, cumin and fennel. Brew 2 teaspoons of the mixture with a glass of boiling water, leave for 15-20 minutes, strain, drink a third of a glass 3 times a day for half an hour before meals. Please note that for this collection, the seeds must be ripe.
• In equal proportions, take oregano herb, rowan fruit, gray blackberry leaves, nettle herb and fennel fruit. Brew a tablespoon of the collection with 1 cup of boiling water, insist in a thermos for 1.5 hours, strain, take a third of a cup 3 times a day after meals.

Attention! The use of horse chestnut preparations (dietary supplements, herbal preparations, creams for the treatment of varicose veins and hemorrhoids) can significantly reduce or even stop lactation.

Physical exercises.

This is the safest and most effective way to get rid of postpartum constipation. Stretched abdominal muscles do not provide full support to the abdominal organs, there is a risk of developing a hernia of the white line (midline of the abdomen), the uterus contracts more slowly. Flabby skin and abdominal muscles do not adorn the figure, exacerbating emotional discomfort. The stretched muscles of the perineum cannot become a reliable support for the pelvic organs - there is a threat that the uterus will descend into the vagina, prolapse or prolapse of the uterus will occur.

Regularly performing physical exercises, you can get rid of extra pounds acquired during pregnancy, improve well-being, increase self-esteem, improve emotional background, and gain strength. It is worth giving exercise 5-10 minutes a day (it is advisable to do a set of exercises several times a day).

In the proposed mode, this complex can be performed by women who have not had a caesarean section or deep tears. If you have had surgery or complex perineal, cervical, or other complications, check with your doctor before exercising.

On the 1st -2nd day after birth:

I. p. - lying on your back, arms loosely along the body, legs slightly bent at the knees, take a deep breath and inflate your stomach, hold your breath a little and exhale with force through your mouth, while trying to pull your stomach in as much as possible. Repeat 5 or more times.

On the 3rd day after birth:

1. I. p. the same, the knees are pressed to each other. Simultaneously with the usual breath, strongly tighten the muscles of the pelvic floor (as to prevent defecation), holding your breath a little, exhale and relax. Repeat several times.
2. I. p. the same. At the same time, with an inhalation, lift up the right leg and left arm, while exhaling - lower. Then do the exercise with your left foot and right hand. Repeat at least 5 times.
3. I. p. - standing, feet shoulder-width apart, arms extended forward. Without lifting your legs, turn your torso to the right, pulling your right arm back as much as possible (inhale). Return to starting position (exhale). Perform the exercise on the other side. Repeat several times.

On the 4th-14th day:

1. Starting position - as in exercise number 4. Interlace your fingers in a lock in front of you. Turning the torso, try to take your arms as far back as possible. Repeat several times.
2. I. p. - lying on your back, arms lie freely along the body, legs bent at the knees, while inhaling, raise the pelvis and hold it for several seconds, lower with exhalation. Repeat.
3. I. p. - standing on all fours. When inhaling, draw in the stomach and perineum, hold your breath for a couple of seconds, and relax with an exhalation. Repeat.

2 weeks after birth:

1. I. p. - standing. Raise your hands to your shoulders, put your elbows forward. Bending the right leg at the knee and raising it, try to touch the left elbow with the knee. Repeat several times on both sides.
2. Complicate exercise No. 6 by slightly spreading your legs to the sides and at the moment of lifting the pelvis, strain the muscles of the perineum, as in exercise No. 2. Repeat several times.
3. Lying on your back, alternately bring the leg bent at the knee and hip joints to the stomach.

Self-massage of the intestine.

In a standing or lying position, with light movements of any palm, you need to “pass” from the right groin up, then hold the palm above the navel and go down to the left groin. From time to time, movements should be accelerated, giving them the appearance of a slight vibration and undulation. The massage lasts 10-15 minutes. It is better to coincide with the time when there is a desire to empty the intestines in order to develop a conditioned reflex to defecate. The introduction of a candle with glycerin into the anus can also help with this. 20 minutes after this procedure, you must definitely go to the toilet, even if there is no urge to defecate.

It is necessary to sit in the toilet until the desired effect appears, or at least 10-15 minutes with careful straining and an attempt to empty the intestines. When the reflex is restored (the urge to defecate will appear regularly, daily at the same time), candles are canceled.

With atonic constipation in the morning, without getting out of bed, you can vigorously rub the skin around the navel and to the left of it towards the inguinal region with the fingers of both hands. The legs are somewhat bent at the knees. Massage should be done for 4-5 minutes.

With spastic constipation, on the contrary, soft, slightly with pressure stroking the entire abdomen in a clockwise direction helps.

For the prevention and treatment of hemorrhoids, after each act of defecation, be sure to irrigate the anus with a cool shower. You can alleviate irritation with microclysters with linseed infusion (pour a tablespoon with a glass of boiling water and leave for 3 hours; draw 50 ml of slightly warmed infusion into a syringe; the procedure can be repeated several times a day if necessary).

In conclusion, I would like to note that the problem that has become the subject of our conversation is not pleasant, but completely solvable. And if you follow all the recommendations of the doctor, then soon you will be able to cope with it.

This insidious dysbacteriosis ...

The human intestine consists of thin and thick sections. The microflora of the large intestine consists of 90% of microbes that do not need air (anaerobes) to live, and 10% of aerobes. The small intestine is practically sterile. A change in the quantitative and qualitative composition of normal microflora is called the term dysbacteriosis, or dysbiosis. Intestinal dysbiosis can be both a cause and a consequence of constipation.

The reasons for the development of dysbacteriosis are:

• The irrational use of antibiotics, which lead to the death of not only pathogenic (pathogenic), but also beneficial microbes in our body.
• Irrational nutrition.
• Retention of feces in the large intestine.
• Violations of general and local immunity.
• Insufficiency of enzymes of the digestive tract.

Dysbacteriosis in the initial phase is asymptomatic. Subsequently, with the development of the disease, bloating, flatulence, stool disorders (constipation or diarrhea) appear, various allergic reactions to food products may develop. This is due to the fact that the process of digestion of food occurs incorrectly and various toxic substances are formed that are absorbed into the blood and have a harmful effect on all human organs and tissues.

From the point of view of physiology, the act of defecation is a complex process that involves the release of fecal masses accumulated in the intestines from the body into the external environment through the anus. The number of bowel movements per day directly depends on the constitution of a person and the amount of food he ate. However, it is considered normal to have 1-2 bowel movements per day. Frequent emptying or, on the contrary, long delays indicate the development of disorders, in the presence of which medical attention is often required.

Mechanism

Cleansing of the lower intestine occurs during the act of defecation. Shortly before the process of emptying, an appropriate urge is formed in the body. He, in turn, has an irritating effect on the receptors of the intestine at the moment when it is filled with feces and the pressure in it is increased to 50 mm of water column.

The actual act of defecation occurs due to the performance of motor function by the internal and external sphincters. Outside of the emptying process, they are reduced, so that the feces do not fall out of the rectum. In addition, the regulation of the act of defecation is carried out by a special center. It includes the intramural nervous system, as well as the somatic and parasympathetic divisions of the sacral segments of the spinal cord.

Separately, we dwell on what is the mechanism of the act of defecation. From the receptors of the intestinal mucosa, afferent impulses enter the spinal center. This happens through the pelvic and pudendal nerve fibers. In the spinal center, the process of forming impulses is started, which are then transmitted to the internal sphincter of the rectum and its smooth muscles. As for the anal ring, located outside, at the beginning of the reflex, its tone is increased. As soon as the indicator of the suprathreshold strength of irritation of the rectal receptors is reached, the external sphincter relaxes, so that the feces can freely exit the body.

In the commission of an arbitrary act of defecation, the following take part:

• Medulla.
• Hypothalamus.
• The cerebral cortex.

Conscious management of the emptying process is formed already in the first 12 months after the birth of a child.

The natural act is not only volitional. In part, it is also involuntary. After all, with a pronounced irritation of the intestine, the process of its contraction is launched, due to which the sphincters also relax.

Influence on the work of internal organs and systems

During the act of defecation, some changes occur in the tissues. For example, systolic blood pressure rises significantly, on average, by 60 mmHg. The diastolic also changes upwards. As a rule, it rises by 20 mmHg. This is due to the fact that during bowel movement, a large area of ​​muscle tissue is reduced. In addition, at the moments of straining, there is a delay in breathing.

Regularity

Normally, the act of defecation in the average person should occur up to 2 times a day. However, it should not be accompanied by painful and other uncomfortable sensations. In addition, a person should not make pronounced efforts when straining.

The interval between acts of defecation is a purely individual indicator. The average person has a bowel movement in the morning. At the same time, the possibility of cleansing in the evening is not excluded.

Normally, up to 0.5 kg of feces should leave the body per day. Fecal masses should stand out easily, immediately sink and leave no marks on the plumbing. The color of feces is normally brown (except for the days when a person ate a coloring food, such as beets). The consistency of the feces should be soft, but shaped stool.

Why You Shouldn't Suppress the Urge to Defecate

Ignoring the signals of the body (conscious containment of feces in it) leads to excessive stretching of the rectal ampulla. In addition, feces are not only the end product of food digestion. It contains a huge amount of bacteria and toxic compounds. The latter begin to be absorbed into the blood with a long absence of emptying. As a result, a person experiences headache, weakness and other manifestations of the intoxication process.

Types of violations

Situations when bowel movements occur too often or, on the contrary, very rarely, occur all the time. Such conditions can develop under the influence of a large number of provoking factors.

Types of violations of the act of defecation:

1. Frequent stool. In other words, diarrhea. This is a pathological condition in which bowel movements occur 3 or more times a day. At the same time, the stool is unformed, it is liquid in consistency. The daily amount of feces exceeds the norm of 0.5 kg. Liquid feces do not sink and leave marks on plumbing. To identify the pathology that caused the development of diarrhea, doctors initially pay attention to the color of feces. It can vary from light yellow to brown.
2. Rare chair. This constipation is a difficult act of defecation. Bowel emptying occurs, as a rule, 1 time in 3 days. The feces are very hard. During the act, a person has to strain hard. In this case, pronounced painful sensations can be observed.

Neither diarrhea nor constipation are independent diseases. They are always considered as a consequence of the impact on the body of any negative factors.

Causes of violations of the act of defecation

Both frequent and rare stools are conditions that often require medical intervention. However, the causes of their occurrence can be relatively harmless.

Constipation is a consequence of:

The main causes of diarrhea:

• Intestinal infections. It can be both banal poisoning with a low-quality product, and salmonellosis.
• The presence of autoimmune pathologies of the gastrointestinal tract. In this case, the body's defense system regards its own cells as foreign and regularly attacks them. Examples of ailments: ulcerative colitis, Crohn's disease.
• The presence of neoplasms in the colon.
• The production of insufficient amounts of digestive enzymes.
• Violation of the process of regulation of the intestines by the nervous system.
• Taking certain medications (antibiotics, hormonal and anticancer drugs).

If you have frequent episodes of diarrhea or constipation, you should contact your doctor. The doctor will issue a referral for a comprehensive study, based on the results of which he will draw up a therapy regimen or refer him for a consultation with other specialists, for example, a gastroenterologist, surgeon, proctologist or endocrinologist.

Treatment

To get rid of constipation or diarrhea, it is necessary to eliminate the root cause of the development of these pathological conditions. To do this, the patient needs to undergo a comprehensive examination, based on the results of which the doctor will be able to identify the underlying disease.

As practice shows, in many cases it is enough just to adjust the diet and diet, as well as stop taking certain medications. However, the possibility of a serious pathology cannot be excluded.

Prevention of violations

It is possible to significantly reduce the risk of stool disorders, but for this it is necessary to follow the principles of a healthy diet. The daily menu must contain foods rich in vegetable fibers. It is desirable to exclude fatty, fried, smoked and spicy dishes from the diet.

It is also important to treat all identified diseases in a timely manner. If you experience any alarming symptoms, it is recommended to consult a doctor.

Finally

The term "the act of defecation" refers to the process during which the stool passes out of the body. Normally, there should be up to 2 emptyings per day. Too rare or, on the contrary, very frequent stools indicate violations. To identify the underlying disease, you need to see a doctor.

Violations of the act of defecation, such as pain during defecation, false urges, burning, going to the toilet after each meal, or defecation in small portions, can be a sign of a variety of diseases: nervous, endocrine, oncological, and not just rectal fissures or hemorrhoids.
An upset bowel movement can occur for several reasons that are associated with a disorder of nervous regulation and diseases of the pelvic organs, namely the rectum.

Discoordination of the act of defecation

Violations of the nervous regulation leads to a failure in the coordinated work of the smooth muscles of the intestine and the anal sphincter. Anismus- this is a bowel movement in which an involuntary spasm of the sphincters occurs (the name resembles vaginismus, in which a spasm of the muscles of the vagina occurs. There are false urges to defecate, but the act of defecation itself does not occur. Dischesia(dyschezia), dyschezia, essentially constipation, is the most severe manifestation of a violation of the act of defecation, as a result of an excessively weak tension of the muscles of the rectum or a rather strong tone of the anal sphincter. The patient describes that during defecation one has to strain very hard, while helping oneself with pressure on the perineum, but still there is a feeling of incomplete emptying. Dyschesia must be distinguished from a mechanical obstruction to emptying.
The urges that arise cannot realize themselves on their own, even with significant human stress, which leads to chronic and persistent constipation and abdominal pain. Sometimes doctors do not immediately recognize the disease, but perceive it as false symptoms with intestinal atony.

It is clear that not only constipation, but also fecal and gas incontinence can also be associated with a violation of the synchronous work of muscles and sphincters.

Disorders of the act of defecation are determined using defecography. The barium suspension is filled into the sigmoid colon, through the anus and the fluoroscopic method is used to observe how the bowel is emptied. In this way, you can determine the anorectal angle during defecation, prolapse or prolapse of the rectum, weakness of the pelvic floor.
Anorectal manometry documents some parameters of the act of defecation, this study will help determine how the anal sphincter works, the reflex of relaxation of the internal sphincter, when the bowel is filled, the pressure that is perceived as a signal to empty. Both studies are not pleasant, but they need to be done to determine the appropriateness of one or another treatment.

rectal prolapse

This disease develops mainly in women after childbirth, when the pudendal nerve is damaged, as well as in old age. In addition, it is possible with severe persistent constipation. Usually the disease has only one symptom - it is direct prolapse of the rectum, which, if infringed, can cause quite severe pain during bowel movements and burning.
There are 3 types of rectal prolapse:
Complete protrusion of all layers of the intestinal tube through the anus.
Protrusion of the rectal mucosa only
Internal rectal prolapse without external prolapse through the anus.
The treatment of this pathology is mainly surgical, there is no medical treatment.

A type of rectal prolapse in women -.

Sometimes it is not the intestine itself that falls out, but which has a leg.

Haemorrhoids

Hemorrhoids develop a disease with severe forms of constipation, after childbirth, with a sedentary lifestyle or with frequent stress. In the process of defecation, hemorrhoids prolapse through the anus, which causes pain in the anus. Burning in the anus is also one of the manifestations of hemorrhoids.

Fissure of the anus

The causes of an anal fissure lie in the damage to the anal sphincter mucosa by solid feces, loose stools, and also due to exotic sexual relations. In most cases, an anal fissure heals on its own when the stool normalizes or when other factors are eliminated. If rapid healing does not occur, then a chronic anal fissure may form, and the process will be constantly aggravated. Pain during bowel movements will increase the spasm of the anus, which will lead to even more injury to the fissure.
The characteristic symptoms of acute anal fissure are pain during defecation, as well as within a few minutes after it. If the crack goes into a chronic stage, then the pain after emptying the intestines significantly exceeds the pain during the bowel movement itself. Also a characteristic symptom of anal fissure is the appearance of light, scarlet blood in the stool.

Symptoms of violation of the act of defecation

The pathology of the act of defecation may be the result of various pathologies of the intestines and improper food intake and is manifested by the following symptoms:

• Pain after defecation;
• Defecation after every meal;
• Frequent bowel movements in small portions;
• False urge to defecate;
• Feeling of incomplete bowel movement

Pain during and after defecation, as well as soreness in the abdomen, can occur against a background of spasm of the smooth muscles of the sigmoid colon, which occurs with severe constipation that requires powerful tension. Excessive distention of the sigmoid and rectum by feces also leads to abdominal pain for a short time.

Symptoms of inflammatory bowel diseases, such as abscess, infection, hemorrhoids, oncology, can worsen after a bowel movement, therefore, with persistent and prolonged abdominal pain, it is necessary to see a specialist.

Defecation after each meal is most often associated with accelerated peristalsis, which is observed in irritable bowel syndrome. Frequent bowel movements in small portions after each meal is also characteristic of infectious diseases accompanied by diarrhea. Sometimes bowel movements after every meal and chronic abdominal pain are observed in pancreatitis, especially often in alcoholics. Defecation is very characteristic after each meal in women with hyperthyroidism and during menstruation. In all cases, the diagnosis of problems for specialists does not deliver.

False urge to defecate and a feeling of incomplete bowel movement are dangerous symptoms. The urge to defecate occurs when fecal masses act on the receptors of the rectal mucosa. False urge to defecate appear when the mucosa is irritated by something else. An inflammatory process of the rectum, an infection, or oncological diseases can act as an irritant. Alas, false urges do not arise in the first place. With the development of any pathological process in the rectum, not only false urges are characteristic, but also pain during defecation.

Attention! The early ones are very indistinct and non-specific. False urge to defecate, they are also called tenesmus, not a good symptom! It is necessary to address to the gastroenterologist.

Burning during bowel movements: the causes that cause burning are due to the occurrence of damage to the mucous membrane of the rectum or anus. Burning during bowel movements can be caused by mechanical damage when wearing tight and tight underwear. In children, itching and burning are most often caused by helminthic invasions and diaper rash. Hemorrhoids and anal fissures can cause both burning and pain during bowel movements. Polyps of the rectum, when injured by feces, can cause symptoms similar to an anal fissure.

The presence of problems with stools and defecation, constipation, in most cases are the result of eating food that is harmful to the body, and only a small percentage are intestinal diseases and nervous disorders. By following all the rules of a healthy lifestyle, you can forever forget about constipation and other disorders.

Dear friends! The medical information on our website is for informational purposes only! Please note that self-medication is dangerous for your health! Sincerely, Site Editor

Neurogenic disorders of the act of defecation - as an independent symptom complex, and in combination with urination disorders and impotence - are a characteristic manifestation of many neurological diseases.

The main types of intestinal dysfunctions are functional constipation (spastic and atonic) and anal incontinence (gas incontinence, formed and unformed stools). The variety of clinical manifestations and pathological mechanisms underlying the development of these disorders in various neurological diseases indicates the complexity of the nervous reflation of defecation, and an impressive list of drugs | | * oyus 31 groups of drugs), the use of which causes "The cape of the spur, can become a reason for limiting medical appointments.

And the normal frequency of stool in healthy people varies from 3 times a day to

I pa" per week, however, most adults have a chair once a day. The frequency of the stool may change with a change in the usual diet (including the patient's stay in the hospital). Defecation disorders are significantly less common in women than in men.

Determine such important indicators as the consistency and shape of feces! the content of water in it, which in healthy people is 70%. \ I know that constipation stools contain about 60% water. The shape of the feces also depends on her incontinence. The shape of the stool may also depend on the tnus of the intestine and the speed of movement of feces through it.

As a rule, the leading mechanism for the development of a defecation disorder (constipation and fecal incontinence) is a change in the contractile vitality of the large intestine and anorectal zone. However, in a number of cases, spurs in neurological patients arise as a result of situational suppression of the urge to defecate (bed rest, absence or significant removal of the toilet from the ward, impaired motor activity of the patient).

Despite the fact that constipation and fecal incontinence are probably mutually exclusive, the mechanisms that cause them often turn out to be the same and are associated with the level of damage to the central and peripheral links of the regulation of this function.

Complaints presented by a neurological patient with impaired defecation can be subdivided by nature into obstructive and irritative ones, by analogy with LUTS. Obstructive complaints characteristic of constipation include:

bloating,

Abdominal pains of a bursting nature,

The frequency of defecation is less than 1 time in 3 days,

Feeling of incomplete emptying of the rectum

Difficulty in the exit of feces when straining,

The need for strong straining during the act of defecation, despite the urge to it and soft feces,

The need to press the hand on the lower abdomen

emptying,

The need to remove feces with a finger.

Irritative complaints characteristic of urge fecal incontinence include:

The frequency of bowel movements more than 2-3 times a day,

gas incontinence,

Incontinence of dense feces

Incontinence of unformed feces.

When evaluating the symptoms of defecation disorders, it is necessary to pay attention to the following parameters:

Stool frequency (stool diary),

The duration of straining during the act of defecation (min),

Quality, consistency and shape of feces (Bristol stool shape scale; Table 7),

Feeling of complete or incomplete evacuation of intestinal contents,

The presence or absence of anal or perianal pain (pain during defecation is not typical for neurogenic defecation dysfunctions),

The use of finger assistance in the process of defecation.

Offensive odor of feces.

The obstructive type (neurogenic chronic constipation) is characterized by:

Poor colonic replenishment, which may be due to poor dietary fiber (diet analysis).

Slow movement of feces in the colon in the presence of the following symptoms:

No spontaneous urge to defecate

Bloating, bursting pains,

Long history of constipation

Having a neurological disease

Taking medications that cause constipation (including those used in neurology),

feces often resort to digital fecal removal. I.1 straining during defecation leads to a significant rise in intra-abdominal pressure (more than 40 cm of water column), which in turn can cause an increase in intravesical pressure and, as a blindness, the development of vesicoureteral reflux. This fact underlines the connection of the combined development of intestinal and urinary disorders in neurological patients.

One of the most common causes of constipation, both spastic and atonic, is the use of drugs that inhibit the motor activity of the colon. These include:

Antacids containing aluminum hydroxide or calcium carbonate; and. * tion,

Anticholinergic drugs (including those used in the treatment of imperative urination disorders - trotricyclic antidepressants (amitriptyline, imipramine),

narcotic analgesics,

Antihypertensives (α-adrenergic blockers, calcium antagonists, angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors),

anti-tuberculosis drugs,

Antibiotics (gyrase inhibitors, cephalosporins),

Systemic antifungals (ketoconazole),

Iron preparations (its salts),

gestagens,

diuretics,

Lipid-skimming drugs (ion-exchange), ^

Antipsychotics (phenothiazines), "

tranquilizers,

Muscle relaxers.

The irritative type (neurogenic anal incontinence) is characterized by:

Incontinence of stool in the colon with the following symptoms:

Imperative urge to defecate,

Increased urge to defecate up to 3 or more per day,

The presence of a neurological disease.

Anorectal kata incontinence, manifested by:

Involuntary defecation shortly after the onset of the urge,

The presence of soft stools

The need to use sanitary pads and diapers, anal tampons.

According to the classification of anal incontinence proposed

II I. Fedorov et al. in 19X4, neurogenic fecal incontinence refers to the form "without an organic violation of the obturator apparatus-

i.flga "and has three degrees:

I degree - gas incontinence,

II degree - incontinence of unformed feces,

III degree - tight kat incontinence.

This type is characterized by the 5th and 6th types of feces according to the Bristol-Imsh scale, namely feces resembling soft balls with clear boundaries (it comes out easily) and feces resembling soft lumps with fuzzy boundaries.

In a syndromic approach to the description of intestinal symptoms, they clearly use the scale for assessing gastrointestinal symptoms (Table 8).

3. Have you been bothered by acid reflux in the past week?

(Reflux refers to the feeling of spitting up small amounts of acid! or sour or bitter fluid from the stomach to run down the throat) ^

Didn't bother

4. Have you been bothered by hungry stomach pains in the past week? (This is an empty feeling in the stomach associated with the need to snack between meals]

Didn't bother

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort Very severe discomfort

5. Have you been bothered by bouts of nausea in the past week? (Nausea refers to an unpleasant sensation that can lead to vomiting)

Didn't bother

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort d Very severe discomfort

6. Have you been bothered by rumbling in your stomach in the past week?

(Rumbling refers to "vibration" or unpleasant sounds in the abdomen)

Didn't bother

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort Very severe discomfort

7. Have you been bothered by bloating in the past week? ■■1iiJ|L (Bloating refers to the sensation of gas ■***” or air in the abdomen,

often accompanied by an increase in the volume of the abdomen)

PISPOKOILO

Yu.c|||chilling discomfort ^

Minor Discomfort [||»»DII Discomfort

©shockingly strong (but tolerable) discomfort

1. IM1.IY discomfort (111(1 u severe discomfort

8. Have you been bothered by belching in the past week?

(Belching refers to the release of air from the stomach through the mouth, accompanied by a weakening of the feeling of bloating)

Mi peskoila

Irresistible discomfort Starved discomfort S*|N!DAY discomfort

Severe (but tolerable) discomfort

9. Did flatulence bother you last week?

(Meteorism refers to the release of air or gases from the intestines, often accompanied by a decrease in the feeling of bloating)

Ying bothered

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort Very severe discomfort

10. Did you suffer from constipation last week? (Constipation refers to reduced ability to have a bowel movement)

Didn't bother

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort Very severe discomfort

Continuation tail

11. Have you had diarrhea in the past week?

1P ° D DiaRey means emptying the box too often)

Didn't bother

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort Very severe discomfort

„ 12. Did loose stools bother you last week?

"(In the case of alternating loose stools and hard stools, note the degree of discomfort. ;; .ish; with a predominance of loose stools)

Didn't bother

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort Very severe discomfort

13. Have you been bothered by hard stools in the past week?

(In case of alternating liquid stools and hard stools, note the degree of discomfort with the predominance of hard stools)

Didn't bother

Minor discomfort Moderate discomfort Moderate discomfort

Relatively severe (but tolerable) discomfort Severe discomfort Very severe discomfort