Why are diabetics more prone to constipation? In recent years, medical scientists attach great importance to the effect of blood sugar on gastrointestinal emptying. Studies have found that hyperglycemia can slow down the gastric emptying of normal people and diabetic patients. Because obvious hyperglycemia can inhibit the wandering compound movement of normal people in the process of digestion, reduce the amplitude and frequency of gastric antrum contraction, and also affect the starting point of gastric electricity, so that the rhythm of gastric electricity is disordered. It is obvious when the blood sugar is higher than 230, but it has no effect on the gastric electrical rhythm between 140 ~ 175. 66% of diabetic patients have autonomic neuropathy and obvious structural abnormality of vagus nerve, such as axonal demyelination, axonal atrophy and decreased nerve conduction speed, which leads to decreased gastric juice secretion or slow response, delayed emptying, decreased tension or weakness, thus causing gastroparesis, making it difficult for solid food to be discharged from duodenum, and also leading to slow intestinal peristalsis and constipation.
Among the diabetic population, the elderly account for the majority. Due to psychological and neurological factors, the autonomic nerves of the elderly are inhibited, the defecation reflex is slow, the contractility of diaphragm, levator ani and abdominal smooth muscle groups and the secretion of digestive glands are reduced, and the feces are not as soft as adults. Bad teeth, eat less food containing more cellulose; I was sick and took a lot of medicine; Less activity. These factors will lead to difficulty in defecation. Coupled with gastrointestinal motility and secretion disorders caused by diabetes, autonomic nervous disorder is more likely to occur, aggravating the degree of constipation. Once combined with constipation, there will not only be many painful symptoms, affecting the quality of life, but also many serious complications. For example, when cardiovascular and cerebrovascular diseases are combined, forced defecation will cause cerebrovascular rupture, sudden cardiac death, intestinal rupture and perforation, etc., which often have serious consequences. Therefore, diabetics should pay more attention to constipation.
It is better to focus on the prevention and treatment of constipation than on drug treatment. We advocate taking comprehensive measures to prevent the abuse of laxatives and avoid dependence caused by long-term use of laxatives, and some people even have black stool.
First of all, patients should strengthen physical exercise and enhance intestinal peristalsis. Secondly, develop the habit of regular defecation. Don't read books and newspapers when defecating. Relax, open your mouth and breathe. Third, eat a reasonable diet, eat more fruits and vegetables, eat less high-fat diet and drink more water. Fourth, rub your abdomen every day, do abdomen-closing and anus-lifting exercises to improve your defecation ability. Fifth, according to individual differences, we should reasonably choose different kinds of drugs, such as lubricity, irritation, volume, permeability, calcium antagonists, 5-HT4 agonists and so on. Sixth, select traditional Chinese medicines based on syndrome differentiation, such as Simotang, Liuwei Xiaoan, Maren Runchang and Compound Aloe. Seventh, constipation patients often lack Bifidobacterium, which can be supplemented appropriately, which can not only regulate intestinal flora, but also promote intestinal smooth muscle contraction, which is beneficial to defecation.
It is worth emphasizing that the better the blood sugar control, the better the therapeutic effect of constipation.
References:
Wang Runhua, chief physician of Beijing Friendship Hospital.