Secondary constipation

Introduction Constipation, which occurs on the basis of organic diseases or diseases, is called secondary constipation, also known as symptomatic constipation. The main reasons are: (1) constipation caused by long-term living habits of individuals: such as long-term bedridden patients, due to the relationship between body position, the amount of activity is small, the peristalsis is slow, so that the stool stays in the intestine for too long, causing the stool to dry; the elderly suffer from poor tooth function It is accustomed to eat low-slurry foods and eat less vegetables containing cellulose to cause chronic constipation. (2) Constipation caused by certain diseases: metabolic and endocrine diseases, systemic diseases, neurological or psychiatric, anorectal and organic diseases can cause constipation. Patients with respiratory failure and heart failure, as well as multiple organ failure, are unable to defecate and have a sense of fear during defecation, so they do not dare to defecate for a long time, causing chronic constipation. (3) Constipation caused by taking drugs: such as anesthetics, antidepressants, aluminum preparations, calcium channel antagonists, antihistamines, diuretics, etc.; the elderly often have osteoporosis and anemia, long-term use of iron and calcium Agents can also cause constipation. (4) Constipation caused by imbalance of intestinal flora: The intestinal tract is an important immune organ of the human body. If the care is not good, the body's resistance will drop drastically and endanger health. Partial eclipse or overeating, overwork, taking antibiotics, bacterial contamination, and aging are all common causes of changes in the intestinal flora.

Cause

One of the most important causes is endocrine and metabolic diseases, including diabetes, hypercalcemia, hypokalemia, porphyria, hypothyroidism, total pituitary dysfunction, hyperparathyroidism, pseudoparathyroid gland Hypofunction, pheochromocytoma, glucagonoma. These other metabolic and endocrine diseases mainly affect smooth muscle function and cause secondary constipation.

Nervous system diseases are also associated with constipation. Central nervous system (CNS) disease is most closely related to constipation, and disruption of neuromodulation is the cause of constipation. This includes remembering injuries (such as car accidents, falling from heights, etc.), cauda equina, lumbar disc disease, spinal tuberculosis, multiple sclerosis, Parkinson's disease, stroke, and brain tumors. Paraplegia can cause slow emptying. Parkinson's disease causes the contralateral contraction of the anal external sphincter to cause defecation obstruction. Patients with multiple sclerosis have constipation symptoms, and peripheral nervous system diseases such as autonomic diseases, neurofibroma, and ganglionoma are all associated with constipation.

Diseases of the enteric nervous system (ENS) can also cause constipation, such as Hirschsprung's disease, where the normal development of the enteric nervous system is stagnant and a colon of varying length lacks ganglion cells. The lack of these ganglion cells in the myenteric plexus hinders the normal peristalsis of the colon and the reflex relaxation of the anal internal sphincter to rectal dilation. Neurogenic chronic pseudo-intestinal obstruction and long-term abuse of laxatives caused by constipation caused by amateur damage to the enteric nervous system.

an examination

Related inspection

Colonography fiber colonoscopy colonoscopy fecal microscopy

There are many diseases with constipation symptoms. The diagnosis is mainly based on consultation and clinical examination, especially when observing feces and feces, it can be used to identify the symptoms, and if necessary, rectal examination and drug diagnosis can help to confirm the diagnosis.

diagnosis method:

1. Oral changes: When constipation, the mouth is dry, the mouth color is normal or slightly red, there is a thin layer of gray or gray-yellow tongue coating, the mouth is smelly or slightly stinky. The teeth are worn out and the hard palate tends to swell.

2, auscultation: the number of rumen motility is reduced, the duration of each peristalsis becomes shorter, and the peristaltic sound is weakened. The flap stomach and the real stomach sound disappeared. The bowel sounds weaken and sometimes metal sounds can be heard. Heart sounds and lung sounds generally have no change.

3, defecation and fecal observation: laborious when defecation, the discharge of feces is slightly dry, the surface of the feces is black, a small cake or abacus beads. When the illness is heavy, it does not defecate. If the stomach is blocked, it can last for ten days without defecation. When the rectum is paralyzed, a large amount of feces accumulate in the rectum, and it is often necessary to extend the hand into the rectum.

Differential diagnosis

(1) Acute constipation:

Constipation that has recently occurred suddenly refers to acute constipation, including temporary constipation and symptomatic constipation. Temporary functional constipation is caused by sudden changes in the living environment, temporary depression, and eating too little. Once the cause is eliminated, constipation can heal itself. Symptomatic constipation is an organic constipation, caused by disease, often sudden onset, accompanied by other symptoms, such as severe abdominal pain, vomiting. This type of acute constipation is more common in acute intestinal obstruction. This situation should be diagnosed and handled in a timely manner.

(2) Chronic constipation:

Long-term recurrent constipation is called chronic constipation. It can be divided into organic constipation and functional constipation, which is common in the elderly and infirm. Chronic constipation is caused by constipation for a long time and is harmful to the human body. It can seriously affect the quality of life of patients and can also cause serious consequences.

(3) Functional constipation:

Constipation caused by changes in gastrointestinal function, called functional constipation, due to changes in lifestyle, depression, dietary factors, poor bowel habits, and drug effects. For example, people who travel abroad may suffer from constipation due to factors such as changes in their living patterns, changes in their surroundings, and fatigue. This constipation is functional constipation; simple constipation and irritable bowel syndrome are functional. Constipation; if the course of disease has not changed for more than a few years, it is also more suggestive of functional constipation.

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