Traditional Chinese medicine formula for treating constipation
Radix Rehmanniae 25g almond 12g Radix Ophiopogonis 15g Radix Glycyrrhizae 10g Radix Scutellariae 12g Fructus Aurantii Immaturus 12g Radix Scrophulariae 18g Semen Persicae 12g Areca 12g Semen Pruni/kloc A * * * eat four pay, serious can eat more.
Etiology of constipation
Constipation can be divided into two categories: organic and functional.
organic
(1) Intestinal stricture or obstruction caused by organic tumor, inflammation or other reasons.
(2) Rectal prolapse, hemorrhoids, proctoptosis, puborectal muscle hypertrophy, pubic separation, pelvic floor diseases, etc.
(3) Endocrine or metabolic diseases, such as diabetes, hypothyroidism and parathyroid diseases.
(4) Systemic diseases such as scleroderma and lupus erythematosus.
(5) Nervous system diseases, central brain diseases, apoplexy, multiple sclerosis, spinal cord injury and peripheral neuropathy.
(6) Intestinal smooth muscle or neurogenic lesions.
(7) Colon neuromuscular diseases, pseudointestinal obstruction, Hirschsprung's disease, megarectum, etc.
(8) Neuropsychological disorder.
(9) Drug factors: iron, opioids, antidepressants, anti-Parkinson drugs, calcium channel antagonists, diuretics and antihistamines.
2. Function
The etiology of functional constipation is unclear, and its occurrence is related to many factors, including:
(1) Decreased food intake or lack of cellulose or water in food reduces the stimulation to colon movement.
(2) Normal defecation habits are disturbed by intense work, too fast pace of life, changes in the nature and time of work, and mental factors.
(3) Colonic dyskinesia, common in irritable bowel syndrome, is caused by colon and S-type colon spasm. In addition to constipation, abdominal pain or bloating also occurs, and some patients may show constipation and diarrhea alternately.
(4) The tension of abdominal muscles and pelvic floor muscles is insufficient, the driving force of defecation is insufficient, and fecal excretion is difficult.
(5) Abuse of laxatives leads to drug dependence and constipation.
(6) The elderly are weak, have too little activity, have difficulty defecating due to intestinal spasm, or have a long colon.
classify
Constipation is mainly divided into two types according to the pathogenesis: slow transmission type and outlet obstruction type.
(1) Slow transit constipation is caused by the weakening of intestinal contraction, which slows down the movement of feces from cecum to rectum, or the uncoordinated movement of left colon. It is most common in young women and occurs around puberty. It shows that the frequency of defecation is reduced (the frequency of defecation per week is less than 1 time), the frequency of defecation is less, the feces are hard and it is difficult to defecate. There is no stool or hard stool during anorectal digital examination, but the external anal sphincter has normal anal contraction and forced defecation function; The total gastrointestinal or colonic transit time is prolonged; Lack of evidence of outlet obstruction, such as balloon exhaust test and normal anorectal manometry. Increasing dietary fiber intake and osmotic laxatives are ineffective. Diabetes, scleroderma complicated with constipation and constipation caused by drugs are mostly slow transmission type.
(2) Outlet obstructive constipation is due to the disharmony of abdominal, anorectal and pelvic floor muscles, which leads to the obstruction of fecal discharge. It is especially common in elderly patients, and many patients are ineffective in routine medical treatment. The outlet obstruction type can have the following manifestations: strenuous defecation, endless feeling or falling feeling, less defecation, defecation or insufficient defecation; There is a large amount of muddy feces in the rectum during anorectal examination, and the external anal sphincter may contract violently when defecating forcibly; The total gastrointestinal or colon transit time is normal, and most markers can remain in the rectum; Anorectal manometry showed that the external sphincter of anus contracted sharply or the sensory threshold of rectal wall was abnormal during forced defecation. Many patients with outlet obstructive constipation also have slow transit constipation.
Clinical manifestations of constipation
The prevalence of constipation in the population is as high as 27%, but only a small number of constipation patients will see a doctor. Constipation affects people of all ages. There are more women than men, and the older ones are much more mature than the younger ones. Because of the high incidence of constipation and complicated etiology, patients often have a lot of distress, which will affect the quality of life in severe cases.
Constipation is often manifested as: less defecation times and less defecation volume; Defecation is difficult and laborious; Poor defecation; Dry stool, hard stool and unclean stool; Constipation with abdominal pain or discomfort. Some patients are also accompanied by mental and psychological disorders such as insomnia, irritability, dreaminess, depression and anxiety.
Because constipation is a common symptom with different severity, most people tend to ignore it and think that constipation is not a disease and does not need treatment, but in fact it is very harmful. Constipation? Call the police? Signs include bloody stool, anemia, emaciation, fever, melena, abdominal pain and family history of tumor. If there are signs of alarm, you should go to the hospital immediately for further examination.
Constipation diagnosis
Primary constipation refers to constipation caused by no organic diseases. Functional constipation, simple constipation and idiopathic constipation are all primary constipation. 1. Simple constipation: common in eating too little and food residue is insufficient. Due to the lack of fiber, the stimulation to colon movement is reduced; Defecation habits are disrupted, and due to mental factors, changes in life patterns, long-distance travel and other reasons. Daily defecation is neglected and defecation is not timely; Abuse of strong laxatives weakens intestinal sensitivity and forms dependence on laxatives. 2. Idiopathic constipation: intractable constipation without organic diseases and unknown causes, also known as idiopathic constipation.
Temporary constipation: it may be the change of living environment such as traveling and moving, or it may be temporary constipation caused by mental stress and troubles, or it may be due to the reduction of food intake and insufficient defecation reflex in the stomach or colon.
Refractory constipation is a kind of disease with difficulty in defecation at different ages due to the variation of congenital colon and rectal anatomical structure. It is a functional gastrointestinal disorder, that is, no physical lesions can be found, which is mostly caused by tension, stress, gastrointestinal motility disorder or defecation disorder, forming a vicious circle and leading to habitual constipation.
Infantile constipation is a common disease, which means that the stool is dry and hard, the interval is long, and sometimes it is difficult to defecate. Simple constipation is mostly caused by the increase of water and electrolyte absorbed by colon. Neonates who have not discharged meconium 24 hours after birth are highly suspected of obstruction, and should be further examined, such as taking a standing abdominal plain film. Constipation of infants after birth should be differentiated from thyroid dysfunction and Hirschsprung's disease. The barium enema examination of the latter showed segmental stenosis in addition to colonic dilatation, while chronic constipation showed total colonic dilatation. Children's constipation should also undergo detailed physical examination and necessary auxiliary examination in order to distinguish it from neurological or organic obstruction.
Habitual constipation refers to long-term and slow functional constipation, which is more common in the elderly. However, some scholars believe that habitual constipation is not limited to functional constipation, but also includes colonic constipation and rectal constipation. People who have been constipated for a long time have a dull and swollen face, showing an abnormal pathological face. Habitual constipation is common in primary intestinal peristalsis and delayed defecation.
Secondary constipation: any constipation that occurs on the basis of organic diseases or diseases is called secondary constipation, also called symptomatic constipation. There are many diseases with constipation symptoms. Diagnosis is mainly based on inquiry and clinical examination, especially observation of defecation and feces, so as to distinguish syndromes. If necessary, rectal examination and drug diagnosis are helpful for diagnosis.
Spastic constipation belongs to functional constipation, which is caused by excessive colon movement and narrow intestinal cavity, so that stool cannot pass through. Also known as irritable bowel syndrome, manifested as constipation? Alternating diarrhea or chronic diarrhea.
Postpartum constipation: The puerpera's postpartum diet is as usual, but it is difficult to solve the problem of bad stool or dry and painful defecation for several days. It is called postpartum constipation, or postpartum constipation, and it is one of the most common postpartum diseases.