Constipation - a condition which is characterized by the presence of at least two symptoms observed in patients within 2 months or more. Namely:
• delay the evacuation of the contents of the gut (delayed emptying of more than 48 hours)
• Department of defecation of small quantities of feces (stool weight of less than 35 g / day);
• Department of feces a high density, dryness, that hurts anal region and leads to inflammatory processes;
• Lack of a feeling of complete bowel movement after bowel movement;
• a feeling of locking content in the rectum in attempts, occupying the time over 25% of the duration of discharge;
• the need for strong attempts, despite the presence of soft contents of the rectum and the urge to emptying, sometimes need to delete the contents of the finger from the rectum.
• According to various researchers (Nogaller AM, 1988,
Frolkis AV, 1991), chronic constipation observed in 10,5-43% of the population.
The classification of constipation (at Khavkin AI)
Downstream:
- Acute (sudden absence of the chair for more than two days)
- Chronic (more than 3 months.)
On the mechanism of development:
- Cologenic (with or gipermotornoy gipomotornoy dyskinesia)
- Proctogenic
By stage of the flow:
- Compensated (only dietary correction)
- Subcompensated (diet and medical treatment)
- Decompensated (required cleansing enemas)
On etiological and pathogenetic characteristics:
- Alimentary constipation - associated with inadequate intake of food or liquid, with malnutrition (deficiency of calcium, vitamins, fiber, as well as abnormal rhythm power);
- Neurogenic constipation - a manifestation of abnormal viscero-visceral reflexes in peptic ulcer disease, duodenitis, chronic cholecystitis, urolithiasis, and constipation in neurologic diseases - multiple sclerosis, stroke, tumors and injuries of the brain and spinal cord;
- Diskineticheskih (primary dyskinesia intestine against a background of residual-organic CNS)
- The usual (due to the suppression of physiological urges to defecate, mental overstrain, lack of hygiene, prolonged act of defecation have neuropathy, etc.)
- Reflex (secondary Dyskinesia in various diseases, including digestive system)
- Due to organic CNS diseases (neuritis, myelites, myopathy)
- Infectious (after previous infection)
- Psychogenic - due to violations of daily bowel habits for relocation, long trips, prolonged forced bedrest. This also covers constipation in mental illness;
- Hypodynamic
- Mechanical (barriers to advancement of stool - adhesions, tumors, lymph nodes, etc.)
- Due to developmental abnormalities of the colon (congenital megacolon, a movable blind or sigmoid colon syndrome, Pira, Dolichosigmoid, visceroptosia, hypo-and aganglioz)
- Toxic (lead poisoning, mercury, thallium, nicotine, tea)
- Endocrine (hyperparathyroidism, hyperthyroidism, Addison's disease, pituitary disorders, diabetes, pheochromocytoma, hyperestrogenemia)
- Medical (the use of muscle relaxants, ganglioblokatoroi, holinolitikov, opioids, anticonvulsants, antacids, diuretics,
barbiturates, iron supplements and calcium, calcium channel blockers)
- Due to violations of water-electrolyte metabolism (loss of a large amount of fluid deficiency of vitamins B and K, cholestasis)
• delay the evacuation of the contents of the gut (delayed emptying of more than 48 hours)
• Department of defecation of small quantities of feces (stool weight of less than 35 g / day);
• Department of feces a high density, dryness, that hurts anal region and leads to inflammatory processes;
• Lack of a feeling of complete bowel movement after bowel movement;
• a feeling of locking content in the rectum in attempts, occupying the time over 25% of the duration of discharge;
• the need for strong attempts, despite the presence of soft contents of the rectum and the urge to emptying, sometimes need to delete the contents of the finger from the rectum.
• According to various researchers (Nogaller AM, 1988,
Frolkis AV, 1991), chronic constipation observed in 10,5-43% of the population.
The classification of constipation (at Khavkin AI)
Downstream:
- Acute (sudden absence of the chair for more than two days)
- Chronic (more than 3 months.)
On the mechanism of development:
- Cologenic (with or gipermotornoy gipomotornoy dyskinesia)
- Proctogenic
By stage of the flow:
- Compensated (only dietary correction)
- Subcompensated (diet and medical treatment)
- Decompensated (required cleansing enemas)
On etiological and pathogenetic characteristics:
- Alimentary constipation - associated with inadequate intake of food or liquid, with malnutrition (deficiency of calcium, vitamins, fiber, as well as abnormal rhythm power);
- Neurogenic constipation - a manifestation of abnormal viscero-visceral reflexes in peptic ulcer disease, duodenitis, chronic cholecystitis, urolithiasis, and constipation in neurologic diseases - multiple sclerosis, stroke, tumors and injuries of the brain and spinal cord;
- Diskineticheskih (primary dyskinesia intestine against a background of residual-organic CNS)
- The usual (due to the suppression of physiological urges to defecate, mental overstrain, lack of hygiene, prolonged act of defecation have neuropathy, etc.)
- Reflex (secondary Dyskinesia in various diseases, including digestive system)
- Due to organic CNS diseases (neuritis, myelites, myopathy)
- Infectious (after previous infection)
- Psychogenic - due to violations of daily bowel habits for relocation, long trips, prolonged forced bedrest. This also covers constipation in mental illness;
- Hypodynamic
- Mechanical (barriers to advancement of stool - adhesions, tumors, lymph nodes, etc.)
- Due to developmental abnormalities of the colon (congenital megacolon, a movable blind or sigmoid colon syndrome, Pira, Dolichosigmoid, visceroptosia, hypo-and aganglioz)
- Toxic (lead poisoning, mercury, thallium, nicotine, tea)
- Endocrine (hyperparathyroidism, hyperthyroidism, Addison's disease, pituitary disorders, diabetes, pheochromocytoma, hyperestrogenemia)
- Medical (the use of muscle relaxants, ganglioblokatoroi, holinolitikov, opioids, anticonvulsants, antacids, diuretics,
barbiturates, iron supplements and calcium, calcium channel blockers)
- Due to violations of water-electrolyte metabolism (loss of a large amount of fluid deficiency of vitamins B and K, cholestasis)
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