1, psychological factors
Because of the long course of disease, tumor patients are prone to nervous and anxious emotions, which can cause sympathetic nerve excitement, intestinal peristalsis and constipation.
2. Physiological factors
Changes in living environment, especially after hospitalization, will lead to physiological constipation.
3. Dietary factors
During the treatment of tumor patients, gastrointestinal reaction occurred, resulting in a small amount of food entering the gastrointestinal tract. After the remaining small amount of food residue is absorbed by the stomach, it has a weak stimulating effect on the intestinal wall, reducing intestinal peristalsis, insufficient drinking water, less water entering the large intestine, and less intestinal fluid secretion, causing constipation.
4. Activity factors
Patients with advanced cancer often have fatigue, reduced activity, prolonged bed stay and reduced food intake, so constipation is caused by the lack of mechanical stimulation in the intestine.
5. Drug factors
Under the action of chemotherapy drugs, most gastrointestinal tract will have adverse reactions, and direct stimulation to gastrointestinal mucosa is easy to cause nausea, vomiting, diarrhea, constipation, abdominal pain and other symptoms.
At the same time, during radiotherapy and chemotherapy, most patients use antiemetic drugs, such as granisetron and metoclopramide, which will also produce adverse reactions of constipation. In addition, some tumor patients often need drugs to relieve pain, such as morphine acting on opioid receptors in the central nervous system and gastrointestinal tract, which weakens gastrointestinal peristalsis and often leads to constipation.
Traditional Chinese medicine has unique advantages in treating constipation of tumor patients. The attack method is the true and secret main method, in which the heat secret treatment method is purging heat and stagnation, moistening the intestines and relaxing the bowels; The secret recipe of treating qi is to promote qi circulation, guide stagnation, reduce adverse flow and relieve constipation. Commonly used raw rhubarb, mirabilite, betel nut, immature bitter orange, magnolia officinalis, dandelion, senna and other drugs, in order to achieve the functions of promoting qi circulation, purging heat and relaxing bowels.
The treatment of deficiency and secret is mainly tonic, among which the treatment of constipation due to qi deficiency is mainly invigorating qi and spleen, moistening intestines and relaxing bowels; Constipation due to blood deficiency is treated by nourishing blood and moistening dryness, nourishing yin and relaxing bowels; Constipation due to yin deficiency is treated by nourishing yin and moistening intestines, removing dryness and relaxing bowels; Constipation due to yang deficiency is treated by warming yang and relaxing bowels. Radix Astragali, Atractylodis Rhizoma, Radix Ophiopogonis, Radix Scrophulariae, and Herba Cistanches are commonly used to nourish qi and yin, supplemented by Radix Angelicae Sinensis, Radix Polygoni Multiflori, Fructus Aurantii Immaturus, and Cortex Magnolia Officinalis. All the medicines are combined to play the functions of benefiting qi and nourishing yin, nourishing blood and moistening dryness, moistening intestines and relaxing bowels.
After treatment based on syndrome differentiation and prescription medication, more than 90% patients can get good symptom relief. Sometimes patients with obvious constipation often use traditional Chinese medicine as enema to better relieve the symptoms of constipation.
The goal of prevention is to ensure that patients defecate at least once every 1-2 days. The high-risk groups of cancer patients who are prone to constipation are: elderly and frail, bedridden for a long time, drinking less water, dehydration, nausea and vomiting, massive ascites, long-term use of opioid painkillers, chemotherapy, postoperative abdominal surgery, palliative surgery or local recurrence of intestinal tumors, and enterostomy.
For these high-risk groups of constipation, in order to prevent constipation, we should do the following:
1, the diet should be light and easy to digest, eat more dietary fiber such as vegetables and fruits, and supplement the amount of water, which is conducive to maintaining normal gastrointestinal peristalsis and promoting gastrointestinal defecation reflex.
2, according to the physical condition, choose appropriate physical exercise, such as walking after meals, playing Tai Ji Chuan, etc.
3. Try to develop the habit of defecation on time. Pay attention when defecating, don't read newspapers or do other things, and develop good defecation habits.
4. Keep a good mood, develop good sleep habits, and intervene and adjust as soon as possible when you are anxious.
5. Patients who are prone to dry stools can appropriately supplement some foods that moisten the intestines and relax the bowels every day. Such as: bananas, honey, walnuts, whole wheat bread, sweet potatoes, yogurt and so on.
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