Constipation at a young age? A reliable doctor will teach you some effective methods

Have you tried your best but still can't hear the satisfying "dong dong" sound? Haven't had a bowel movement for three days and feel like your stomach is about to burst? Does your stool feel like a big pill, dry and hard? Do you have smelly and bloody stools, or your anus is broken and covered with wounds? Don't worry, a reliable doctor will give you some safe and effective advice.

How does food become poop?

After food enters the human body, it is initially digested and broken down by the stomach before being discharged into the small intestine. The small intestine absorbs fat, protein, glucose, etc. in the food into the blood, and the remaining food residues enter the large intestine. The large intestine then absorbs the water in the food, shapes the excrement, and continuously squeezes and concentrates it to form excrement[1].

Secondly, what is constipation? When should you see a doctor?

Constipation is a symptom or group of symptoms characterized by difficulty in defecation and/or decreased frequency of bowel movements, hard and dry stools. Difficulty in defecation includes straining, difficulty in defecation, a feeling of incomplete defecation, a feeling of anorectal obstruction, time-consuming defecation, and the need for assistance. The frequency of bowel movements decreases to less than three bowel movements per week. Chronic constipation lasts for at least six months. [5]

Constipation is very common, but diagnosis and treatment are not simple at all. Therefore, professional matters should be handled by professionals, and never miss any abnormal signals from the body.

Constipation can be divided into organic, functional and drug-related according to its cause.

Organic diseases include colon tumors, diabetes, and neurological diseases. Constipation may be just one of the manifestations. Do not delay the diagnosis of the disease. Functional diseases include functional constipation and functional defecation disorders. For example, during defecation, if the muscles of the pelvic floor and anus have anatomical and functional abnormalities and lose effective coordination, such as rectal mucosal detachment, intussusception, rectal protrusion, puborectalis muscle spasm, etc. [7-8] . Regardless of which one, a specialist is needed to confirm the diagnosis. Do not blindly take medication.

If any of the following problems occur, you should first see a doctor to find out the cause behind your constipation:

New onset of constipation that lasts more than 4 weeks.

Obvious symptoms: The severity of constipation can be divided into mild, moderate and severe. Mild constipation does not affect daily life and can be recovered through overall adjustment and short-term medication. Severe constipation refers to severe and persistent constipation symptoms that seriously affect work and life, requiring medication, and cannot be discontinued or medication is ineffective. Moderate constipation is between mild and severe.

Accompanied by other symptoms, such as blood on toilet paper, abdominal mass, alternating constipation and diarrhea, weight loss, obvious fatigue, etc.

Positive fecal occult blood and unexplained anemia were found.

You are older than 40 years old.

You have a family history of digestive tract cancer.

Generally speaking, the prevalence of chronic constipation among adults in my country is 4.0% to 10.0%. The older you are, the higher the incidence is, and it is slightly higher in women than in men. If there are no medical conditions mentioned above, most people can choose to empirically treat constipation at home. Which methods are more reliable? The following solutions come from guidelines issued by authoritative organizations such as the Chinese Medical Association. You may want to try them.

1. Check the prescription and be careful of the side effects of the drug:

If you happen to be taking medication recently and have a new onset of constipation, please first rule out side effects caused by medication, food or supplements.

The use of certain drugs is also a risk factor for constipation, including anticholinergic drugs, opioids, antidepressants, antiepileptic drugs, antihistamines, antipsychotics, antiparkinsonian drugs, antispasmodics, calcium antagonists, calcium supplements, iron supplements, antidiarrheal drugs, NSAIDs, etc. Even laxatives may aggravate constipation. Who would have thought? But it is true, and it varies from person to person.

It is recommended to check the drug instructions or consult a doctor before taking the drug. If you are not sure, you can also try to stop taking the drug and observe whether the constipation improves. Simplifying the medication is actually a good way to cure the disease.

2. Increase dietary fiber and water intake

Dietary fiber has an anti-hydrolysis effect on certain enzymes in the small intestine and is not absorbed by the colon, so it can retain water in the intestinal cavity and increase the volume of feces. During the formation of feces, water is continuously absorbed. If there is less water and dietary fiber in the raw materials, the transportation of feces will be more difficult, and the difficulty of excretion will also increase. Therefore, people who are losing weight and the elderly who have poor chewing ability and eat too little are prone to constipation [1-3].

The recommended intake of dietary fiber is 20-35 g/d, and soluble dietary fiber is particularly recommended. Whether insoluble fiber has a laxative effect is still controversial, but it should be noted that some constipated patients may experience increased abdominal distension, abdominal pain, bowel sounds, and other discomforts after increasing dietary fiber, which is due to increased intestinal gas production caused by increased dietary fiber.

Whole grains, beans, vegetables and fruits are rich in dietary fiber, generally with a content of more than 3%. Whole grains and beans include millet, corn, mung beans, red beans, buckwheat, oatmeal, etc. Dietary fiber mainly includes cellulose, lignin, resistant oligosaccharides, pectin, resistant starch, etc., as well as other indigestible carbohydrates. Cellulose and hemicellulose are the main components of all plant cell walls. Coarse grains, beans, vegetables, fruits, and potatoes are all good sources of cellulose and hemicellulose.

Consuming 2 L of water per day will enhance the laxative effect of dietary fiber, so many constipation guidelines recommend a water intake of 1.5 to 2.0 L/d.

Therefore, do not wait until you are very thirsty to drink water. The daily water intake for adults is between 1500 and 2000 ml. In addition, you should eat more foods rich in dietary fiber [4-5].

3. Exercise regularly

Life depends on movement. Sitting or lying in bed for long periods of time will affect gastrointestinal function. The peristalsis of the colon slows down, and the strength of the rectum and anus weakens, so there is no strength to transport feces [6-7]. People who do not exercise enough and pregnant women [5] will suffer from constipation [3].

Regular physical exercise can shorten intestinal transit time and facilitate defecation. Aerobic exercise such as walking and cycling is effective in improving constipation. There is no strict limit on the frequency and degree of participation of patients with constipation in other sports. The generally recommended amount of exercise is 30 to 60 min/d, at least twice a week. Appropriately increasing the amount of exercise may be more effective for patients with less daily exercise or elderly constipation.

4. Develop good bowel habits: People have three urgent needs, time and posture are important

When your intestines tell your brain that you want to defecate, your brain ignores defecation because of the stress [3,5]. Slowly, the stool will accumulate. Over time, the rectum will adapt to our gradually increasing "defecation warning line" and become less sensitive to the volume of stool, causing functional constipation [1]. This often happens to people who are under great pressure and like to hold their stool. Therefore, when traveling or when your pace of life changes, do not suppress your urge to defecate. Once you feel the urge, you should go to the toilet in time. When you go to the toilet to defecate, you need to concentrate and avoid being disturbed by factors unrelated to defecation, and develop good bowel habits.

Defecation time pattern: The standing reflex in the morning can promote colon movement and help produce the urge to defecate. Surveys show that most people defecate in the morning, men generally defecate between 7:00 and 8:00 in the morning, and women defecate about an hour later than men.

In addition, the gastrocolic reflex and duodenocolic reflex induced by the expansion of the gastric antrum after a meal and the entry of food into the duodenum can promote the group peristalsis of the colon, produce a defecation reflex, and facilitate successful defecation.

Therefore, it is recommended that patients with constipation try to have a bowel movement in the morning and within 2 hours after a meal.

The best posture for defecation: Studies have shown that compared with sitting defecation, abdominal pressure does not increase significantly when squatting, and the puborectalis muscle relaxes at this time, the rectal anorectal angle becomes larger during defecation (greater than normal sitting, 126° vs. 100°, P<0.05), the rectal lumen becomes straighter, and the rectal strain required for defecation is smaller, which is conducive to the discharge of feces; squatting defecation can shorten defecation time, improve defecation effort, and improve patient defecation satisfaction. Therefore, it is recommended that patients with constipation adopt the squatting defecation posture.

Secretly, if the toilet at home is not convenient to convert to a squat toilet, it is said that moving a small stool and standing on tiptoe when defecating can have the same effect.

Bad mood?

Clinically, it is found that constipation is closely related to the patient's mood. Psychological factors such as anxiety, depression and adverse life events are also risk factors for constipation. Live a regular life to avoid stress and stay up late, develop the habit of going to bed early and getting up early, and go to bed on time, and improve anxiety. Use hobbies to relieve stress after work and try to keep a good mood, which will help balance the nerves and keep the stomach unobstructed. When negative emotions arise, adjust your mental state in time. If it is serious, you can consult experts related to psychological or mental illness.

What? You tried all those methods? No effect?

Then go and register decisively. Find a reliable doctor to check you out and take medicine. Your bowel movements will improve and your mood will also improve. There are many medicines for constipation now, both Western and traditional Chinese medicine, which are safe and effective. In short, don't bear it.

In short, if you want to feel happy, make your intestines feel happy first.

References:

[1] Wang Tinghuai. Physiology. [M]. Beijing: People's Medical Publishing House. 2018-8.

[2]CHU H, ZHONG L, LI H, et al. Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in china［J］． Gastroenterol Res Pract, 2014, 2014: 532734. DOI: 10. 1155 /2014 /532734.

[3] Yang Yi. Effect of dietary intervention on the maintenance of therapeutic effect of functional constipation[D]. Beijing University of Chinese Medicine, 2016.

[4] Han Dong. Dietary fiber and intestinal health[J]. Chinese Journal of Microecology, 2013, 25(10): 1225-1228.

[5] Consensus of Chinese experts on chronic constipation (2019, Guangzhou)[J]. Chinese Journal of Digestion, 2019(09):580-581-582.

[6] Zhang Dongming. Pelvic floor and anus. [M]. Guiyang: Guiyang Science and Technology Press. 2000-2.

[7] Zhang Jingyuan. Consistency between rectal examination and high-resolution anorectal manometry in the diagnosis of outlet obstruction constipation[D]. Shandong University, 2014.

[8] Dong Zilong, Zhang Shengbin. Advances in the understanding and treatment of outlet obstruction constipation[J]. Chinese Medical Innovation, 2014, 11(27): 147-149.

The article is produced by Science Popularization China-Starry Sky Project (Creation and Cultivation). Please indicate the source when reprinting.

Author: Xu Lang Popular Science Creator

Reviewer: Lai Yamin, deputy chief physician, Department of Gastroenterology, Peking Union Medical College Hospital