What is constipation?
Constipation mainly refers to a decrease in bowel movement frequency, with fewer than 2-3 bowel movements per week, or once every 2-3 days, and small, dry stools.
What are the clinical manifestations of constipation?
Medical constipation is a common and complex clinical symptom, not a disease. It mainly refers to reduced bowel movement frequency, reduced stool volume, dry stool, and difficulty in defecation. It is necessary to consider the characteristics of the stool, my usual bowel habits, and the difficulty in defecation to determine if constipation is present. If it lasts for more than 6 months, it is considered chronic constipation.
How to treat and prevent constipation?
1. Volumetric laxatives. These mainly include soluble cellulose pectin, plantain, oat bran, etc., and insoluble fiber plant fiber, lignin, etc. Volumetric laxatives have a slow effect, few side effects, and are safe. They are effective for constipation during pregnancy or mild constipation, but are not suitable as a rapid defecation treatment for temporary constipation.
2. Lubricating laxatives can lubricate the intestinal wall, soften the stool, and make it easier to pass. They are convenient to use, such as glycerin suppositories, mineral oil, or liquid paraffin.
3. Saline laxatives. Such as magnesium sulfate and milk of magnesia can cause serious adverse reactions and should be used with caution in clinical practice.
4. Osmotic laxatives. Commonly used medications include lactulose, sorbitol, and polyethylene glycol 4000. These are suitable for temporary treatment of fecal impaction or chronic constipation and are a better choice for constipation patients who do not respond well to bulk-forming laxatives.
5. Stimulant laxatives. These include herbal laxatives such as rhubarb, frangipani bark, senna leaf, and aloe vera; phenolphthalein, castor oil, and acetaminophen. Stimulant laxatives should be used when volumetric laxatives and saline laxatives are ineffective. Some are quite strong and not suitable for long-term use. Long-term use of quinone laxatives can cause melanosis coli or laxative colon, leading to smooth muscle atrophy and damage to the myenteric plexus, but it also worsens constipation; these effects are reversible upon discontinuation.
6. Prokinetic agents. Mosapride and itopride promote gastrointestinal function, while prucalpiride can selectively act on the colon depending on the situation.