Difficulty with bowel movements, unfortunately, is the most common problem in our time. Moreover, constipation occurs both in infants and in adults. Most often, functional constipation is diagnosed, which does not develop due to pathologies and abnormalities of the intestine. What are the symptoms and causes of this disease? How is he diagnosed? How to prevent the development of constipation than to treat it? All this and much more will be discussed in the article.
General concepts of the disease
Functional constipation is a painful bowel movement, it is accompanied by tension and a feeling of heaviness in the stomach, a feeling of incomplete emptying. Most often, constipation occurs due to impaired bowel motility.
According to the international classification of diseases, common intestinal disorders, which include functional constipation, according to ICD-10 have the code K59. But in this classification there are units. Therefore, if we talk about an updated diagnosis, the functional constipation according to ICD-10 goes under code number K59.0.
Constipation is classified as functional if there is a strong tension, hard feces and low weight, and false desires are also observed.
Kinds
Functional constipation is divided into two types.
- Spastic - occurs against a background of severe psychological shock or stress. The muscles of the digestive system are intensively contracted, resulting in impaired intestinal motility. In addition, cracks in the anus or diseases of the endocrine system may be the cause of this type of constipation.
- Atonic constipation - occurs when the diet and the rules of proper nutrition are not observed, a sedentary lifestyle. The intestinal muscles weaken and are unable to cope with their functional task.
Defecation rate (by age)
Defecation rates depending on age are different.
In children up to a year, feces should be soft, mushy. If the baby is breastfed, then almost before the introduction of complementary foods, bowel movement occurs after each feeding.
In infants, pseudo-constipation can be diagnosed, with it the lack of stool is due to the fact that the mother has little milk, or if the child spits up a lot. At high temperatures, babies can also develop constipation, as it leads to dehydration of feces. Temporary problems with bowel movements due to a lack of vitamin D in the body or its excess in the diet may be observed.
If the child is on an artificial or mixed type of feeding, then the stool is observed up to 2 times a day. After the introduction of complementary foods in all children, the number of bowel movements is approximately 2 times a day.
In children under 3 years of age, bowel movement should be at least 6 - 7 times a week, defecation is considered normal for older children at least three times a week, in adults - at least two times within 7 days.
Symptoms
The main sign of constipation is the absence or delay of bowel movements, but in addition to this, the following symptoms can be observed:
- With atonic constipation a lot of feces, they are sausage-shaped. The first part is sealed, its diameter is more than normal, the final part is half-formed. Often the hard part injures the intestinal mucosa, as a result of which blood may be present in the feces.
- With spastic constipation, feces resemble sheep. Toddlers may have colic. After emptying, the feeling remains that the intestines are still full.
- Often with constipation, gas formation is observed, abdominal pain, which intensifies with stress and disappears after bowel movement.
- With prolonged absence of stool, fatigue, lethargy, irritability, pallor of the skin, a tendency to purulent rashes, and a decrease in working capacity can be noted.
- With the loss of the emptying reflex, the following symptoms are observed: stool retention can be 5-6 days, a feeling of heaviness in the abdomen, pain that disappears after emptying.
- If constipation is associated with irritable bowel syndrome, then its symptoms are: alternation of hard and loose stools, with stress, problems with emptying intensify, traces of blood are observed in the stool, the child is diagnosed with anemia, he is losing weight very much.
Chronic functional constipation can cause the following complications:
- proctosigmoiditis;
- hemorrhoids;
- secondary colitis;
- anal fissures.
Signs of the disease
The main signs of functional constipation:
- lack of bowel movement for 3 or more days;
- discomfort and difficulty during bowel movements;
- recurrent abdominal pain;
- feeling of heaviness;
- white coating on the tongue;
- fatigue, lethargy;
- partial or complete lack of appetite;
- nausea;
- gas formation;
- colic
- feces are similar to sheep (spastic constipation);
- traces of blood in the stool.
Causes of constipation in children
Functional constipation in children can be triggered by various causes.
In infants, the causes of constipation:
- impaired intestinal motility;
- prematurity, due to which there is a delay in the production of intestinal enzymes;
- fetal hypoxia;
- damage to the central nervous system;
- rickets;
- premature introduction of complementary foods;
- improper nutrition of a mother who is breastfeeding;
- the transfer of the baby from breastfeeding to artificial;
- replacing one milk mixture with another;
- iron deficiency.
The cause of functional constipation in young children, primary school children and preschoolers may be:
- suppression of the defecation reflex;
- neurosis associated with parting with parents;
- anal fissures and fear of pain, which may be during bowel movements.
It should be borne in mind that stool delays may be due to a malfunction of the thyroid gland.
The cause of functional constipation in children may be prolonged medication. Some of them inhibit the work of the areas of the brain that are responsible for bowel movement, lead to the elimination of potassium from the body, which stabilizes the movement of feces in the colon.
Causes of constipation in adults
The causes of functional constipation in adults can be:
- diabetes;
- functional disorders of the thyroid gland;
- overweight;
- physical inactivity;
- ischemic colitis;
- taking certain medications;
- neurological diseases;
- stress
- suppressing the urge to empty;
- intoxication of the body with salts of heavy metals;
- hungry diets;
- the predominance of sweet and fatty foods in food;
- insufficient fluid intake;
- passive lifestyle;
- abuse of laxatives, resulting in a "lazy bowel syndrome";
- abuse of antibiotics, anti-inflammatory drugs, antidepressants.
Diagnosis of the disease
If constipation occurs, then the cause of their appearance should be established. To do this, appoint:
- X-ray of the intestine, with which you can evaluate the anatomical state of the intestine, exclude pathology, neoplasms, anomalies;
- colonoscopy (examination of the inner surface of the colon using an endoscope);
- fecal examination;
- Bakseeding.
In addition, factors that can trigger the development of constipation should be excluded: nutrition features, drugs, concomitant anomalies and pathologies.
In the case of prolonged and frequent physiological constipation, you should contact your gastroenterologist as soon as possible. Depending on the causes and severity of the disease, the doctor selects the optimal treatment regimen.
Methods of treatment in adults
In the treatment of functional constipation, diet therapy is of great importance. The patient’s diet should be dominated by products that increase the volume of feces, as well as increase the speed of his evacuation. These products include:
- fruits and berries (cherries, raspberries, apples, plums, rose hips);
- bran;
- seaweed;
- prunes
- mushrooms;
- legumes;
- pumpkin, cucumber, zucchini, turnip, radish.
Do not eat: white bread, semolina, rice, muffin, as well as smoked, fatty, salty dishes.
For constipation, drink at least 1.5 liters of plain water per day.
The doctor, if necessary, can pick up laxatives, which are divided into 4 groups, depending on the mechanism of action:
- Drugs that are not digested, they swell in the intestines and contribute to the evacuation of feces: flax seed, plantain-based drugs.
- Means that retain water in the intestine, as a result of which the amount of feces increases, include “Forlax”, “Fortrans”.
- Medications based on lactulose - "Dufalac", "Normase." In the intestines, the drug becomes the soil for the propagation of microorganisms that break down lactulose, enhance motility, increase the volume of feces and accelerate its excretion from the body.
- Drugs that enhance intestinal motility include Senna (Senadexen, Senade, Bisacodyl). The effect occurs 7-8 hours after administration.
If constipation torments for a long time, and laxatives do not work, this may indicate a severe pathology of the digestive tract. Self-medication in such a situation is dangerous. The course of treatment should take place in a hospital under the supervision of specialists.
Methods of treatment in children
The following drugs and agents are recommended for the treatment of functional constipation in children:
- Laxatives "Dufalac" and "Senada", which are given to children in much lower doses than adults. Only a doctor should select a dosage.
- Microclyster “Microlax” is a very convenient laxative with a quick action, it is intended for introduction into the rectum. The drug is safe for infants and has virtually no side effects.
- A light massage of the abdomen should be performed in circular movements clockwise.
- Proper nutrition (vegetables, fruits, soups, dairy products, semi-liquid cereals, olive oil).
Features of the treatment of infants
If the baby has constipation, you should definitely contact your pediatrician to establish the real cause of the disease.
The following clinical guidelines should be followed for functional constipation in children (infants):
- if the baby is breastfed, her mother should adhere to a strict diet;
- in addition to milk, you need to give the child a drink of liquid during the day to prevent hardening of feces;
- it is recommended to give mixtures that contain live bacteria and lactulose;
- after 6 months, children can be given a decoction of prunes;
- buckwheat and oat are best suited from cereals; they stimulate the work of the stomach and intestines well;
- you can put a gas outlet tube or glycerin candle, the effect occurs within a few minutes.
- if the tummy does not hurt, then you can do massage and gymnastics.
Prevention
To prevent constipation, you must adhere to the following rules:
- drink more fluids;
- do not eat harmful foods (fast food, chips, fizzy drinks, sweets, pastries, fatty meat, strong black tea, smoked foods, spicy dishes);
- the daily diet should contain fruits, vegetables, buckwheat or oatmeal, bran bread, prunes, berries, green tea.
- lead an active lifestyle, you can do light sports, gymnastics, hiking;
- take vitamin complexes;
- avoid stress.
Functional constipation is a serious reason to consult a doctor, as delayed emptying may indicate pathologies of the internal organs (bowel obstruction, tumors, endocrine disorders). Laxatives help, but do not eliminate the true cause. In addition, do not abuse them, as this will only exacerbate the situation.
Conclusion
Constipation is not a sentence, but a temporary nuisance. To get rid of it, you need to eat right, lead a healthy and active lifestyle. Eat more foods rich in fiber, try to empty the intestines at the same time. Do not take laxatives very often, as addiction to them occurs, as a result of which the intestine loses its ability to naturally empty.