You who are reading this article again may have had similar experiences or doubts. Can constipation lead to colorectal cancer? Is there any basis for accommodation theory? How to pay attention to changing the most suitable defecation habits? Today, we use this article to answer your questions one by one.
"Constipation only recently", be careful of changing defecation habits!
Usually when it comes to constipation, everyone understands that defecation is not smooth, or for a long time; But as for what is "long-term" or "not smooth", everyone may express it separately. According to the survey, many healthy people go to the toilet once every two days, so it is not necessarily normal to defecate every day. In medicine, it is basically constipation that defecates less than three times a week, accompanied by a certain proportion of hard stool, internal urgency, or difficult to solve, and lasts for more than three to six months.
Why does it take a while? If it is a few weeks to a month or two, you need to consider other physical diseases, such as intestinal obstruction, tumor, hypothyroidism, hypercalcemia, neuropathy and so on. Strictly speaking, the new difficulty in defecation or diarrhea and soft stool within three months can be called a change in defecation habits, and it is really necessary to see a doctor for further evaluation and examination. Thanks to the developed media, everyone is particularly alert to this situation now. If the number is too large, someone will really get colorectal cancer.
However, chronic constipation is different. Except for diabetes, endocrine diseases, long-term bed rest and drug induction, there are usually no other obvious diseases, which are mainly related to physique, diet and living habits. As long as you increase the fiber intake of vegetables and fruits, drink more water and exercise more, even if you don't use drugs, it may be improved. At this time, some people will ask: "If defecation is not smooth for a long time, will harmful substances accumulate in the large intestine, leading to an increase in the incidence of colorectal cancer?" 」
Mythbusters: the myth of defecation and toxin
Let's first consider the logic of this so-called evil accommodation theory. Generally speaking, feces are full of toxins and bad bacteria, so it is necessary to shorten the time it stays in the human body as much as possible. If constipation makes rice fields stay in the body for too long, it will cause intestinal lesions and produce colorectal cancer. As for how to defecate, the specific way can be to eat more fruits and vegetables or take traditional Chinese medicine (natural health school), eat healthy food such as probiotics (biotechnology school), and even regularly * * * large intestine hydrotherapy school like Mrs. May-ling Song.
Unfortunately, the above statement is unfounded in modern medicine. The movement of feces in the intestine is always "pushing feces to the back" (strictly speaking, it is the spontaneous peristalsis of the intestine), and the intestine is not regulated by Lao Ji-fa. Even when we are resting and sleeping, the gastrointestinal tract will constantly turn the food we eat into feces. In other words, everyone is more or less covered in feces under normal physiological conditions. If you don't discharge it for a few days, you can pile it up for a few days at most, which is also the range that the intestine can accommodate, and there will be no so-called accumulation of old feces in the human body.
Therefore, it is very normal to see images of fecal residue on abdominal X-rays. Unless the intestine is abnormally enlarged, it is difficult to judge whether it is abnormal by the distribution of feces. As mentioned above, sometimes doctors will mention a lot of stool when they see a doctor, but in fact, many times it is just for the convenience of explanation. In fact, it is precisely because there is feces in the large intestine at any time, so it is necessary to drink laxatives to help clean up before colonoscopy.
Even if there is no so-called old stool, but long-term constipation will make the stool stay longer, won't it be a problem? This idea is widely spread, but there are two important loopholes in logic, which have also been denied by realistic research. First of all, if constipation is easy to cause toxin accumulation, and it is easy to get colorectal cancer in the future, then the proportion of constipation in women is higher than that in men, and colorectal cancer should be more. The fact is that men are more likely to suffer from colorectal cancer; Similarly, the proportion of constipation in young women is much higher than that in men, but they are the group with the lowest proportion of colorectal cancer; On the contrary, smoking, heredity and obesity are more related to early-onset colorectal cancer.
Chronic constipation has nothing to do with colorectal cancer, but adequate fiber is beneficial.
In a heavyweight systematic review of 20 13, after analyzing 28 studies, it was found that there was no evidence that long-term constipation was related to colorectal cancer if the design and rigor of the studies were considered. The author even noticed that patients who complained of constipation were less likely to find colorectal cancer (compared with other conditions such as bloody stool, age and family history). As we mentioned earlier, the definition of constipation is often "self-determined", so if the study is not well designed, it may include some patients with changed defecation habits, which will affect the final result.
However, several other studies mentioned that for patients with long-term constipation, using fiber formula to promote defecation seems to reduce the risk of colorectal cancer more than non-fiber formula (HR = 0.4495% CI: 0.2 1-0.95), but it did not reach statistical significance. Because patients with long-term constipation usually take medicine for a long time, it has been discussed in the past whether various laxatives will cause long-term sequelae, and there is no clear conclusion so far. However, according to the research in the previous paragraph, it is reasonable and possible to eat enough fruits and vegetables and take fiber as the first line of constipation prescription. Because a large number of fruits and vegetables, as well as reducing red meat, have the effect of reducing colorectal cancer.
As for why long-term constipation can lead to colorectal cancer, why is this concept widely circulated? There are probably several reasons: in addition to its self-evident logic, the appearance of feces can easily lead us to have bad associations, and the public's fear and concept of "toxin" provides a solution for "detoxification" and has the motivation to promote it in business. Finally, the popularity of examination increases the chances that people around you will be diagnosed with colorectal cancer at an early stage. This is actually a good thing, but it may also make the fear of cancer more realistic to some extent, and will take the initiative to do something to avoid this situation, so the concept and action hit it off.
For people at risk, regular screening is more important than paying attention to symptoms.
Finally, let me talk about my two feelings: first of all, just because it sounds reasonable doesn't mean it's right. Adaptation theory, like many specious theories, applies several practical concepts to connect our life experiences, so it sounds particularly convincing. To demonstrate it, the most important thing is to rely on a large-scale study of the real world. The biggest disadvantage of this theory is that it makes many people have unnecessary fears and affects the allocation of medical resources. I hope that after reading this article, I can solve some people's worries and puzzles.
The second feeling is that the early prevention and treatment of colorectal cancer should enter a new stage. In the past, people mostly emphasized which symptoms (iron deficiency anemia, bloody stool, change of defecation habits, weight loss) were related to colorectal cancer, but once such symptoms appeared, it was basically not early colorectal cancer. Although these propaganda is very important, a more efficient way is to nip in the bud, that is, to find polyps that have not yet become cancerous or early colorectal cancer. In this way, the effect of treatment and the quality of life of patients will be better.
The most practical way to achieve this goal is to popularize effective screening. Including the current biannual fecal occult blood of people over 50 years old in national health institutions, as well as the follow-up high-quality colonoscopy. Experience in the United States has confirmed that effective screening can reverse the incidence and mortality of colorectal cancer. At present, about 60% of people over 50 years old in Taiwan Province Province have had a stool examination. For younger people, they can also refer to family history or other risk factors to arrange examinations. If we continue to work hard, maybe in five to ten years, we will pull colorectal cancer down from the throne of "cancer king".