The constipation is a delay of a chair more than for 48 hours.
Constipations belong to frequent disorders of health and, according to medical statistics, occur especially often in small children and elderly people. In the advanced countries of the West to ten percent of the population have chronic (constants) constipations, and they meet at women three times more often than at men. Almost all people have constipations on travel, after a stress and operation. Such constipations pass at return to usual lifestyle and are not considered as a disease. If they often repeat, become usual, it is necessary careful diagnostics and treatment.
The causes of constipations are various:
- the diet poor in vegetable fibers, in combination with a small amount of the consumed liquid and inactive lifestyle;
- digestive tract diseases (peptic ulcer, chronic pancreatitis, dysbacteriosis, irritable colon, tumors of a large intestine);
- accumulation of the hardened stool in intestines ("fecal stones");
- anus diseases (anal cracks, hemorrhoids, paraproctitis) which are followed by the profound pain and interfering bowel emptying;
- neurologic diseases (stroke, Parkinson's disease, damages and tumors of a spinal cord, multiple sclerosis);
- diseases of an endocrine system (hypothyroidism, diabetes, etc.);
- intake of some drugs (atropine, baking soda, Almagel, cocaine, etc.);
- long depression.
Treatment of a constipation, constipation medicine
- Diet with inclusion of the products rich with cellulose: vegetables, fruit, rough black bread (sometimes specially food bran) and there is not less than 2 liters of liquid in day. It is regularly necessary to eat, at least 5 times a day;
- Medicinal (oil with fish oil, sunflower oil, etc.) and cleansing enemas;
- Cancellation of the drugs weakening reductions of intestines (atropine, baking soda, Almagel, some antidepressants);
- If the listed above measures are insufficiently effective, appoint depletive;
- If persistent constipations are caused by a tumor intestines, surgical treatment is necessary.
There are several groups of depletive into which it is possible to divide the main drugs which are applied at a bowel emptying delay.
The stimulating laxatives
It is, perhaps, the most famous group of depletive. The stimulating laxatives irritate nerve terminations of a mucous membrane of a large intestine, reflex strengthen a vermicular movement and promote accumulation of water and electrolytes in an intestines gleam. In addition, increase the volume of intestinal contents and increase motility of a large intestine that the calla leads to stimulation of the act of defecation and acceleration of evacuation.
Phytodrugs on the basis of herbs (Senna, a buckthorn, a rhubarb, an aloe) and also a number of synthetic connections belong to this group (diphenylmethane, bisacodyl, sodium pikosulfat, ritsinoliyevy acid from castor oil).
Active agents of plant origin on the basis of Senna – a sennozida – cause chemical irritation of the receptor device of a large intestine, especially a colon, stimulating a vermicular movement; restore normal functioning of intestines, without causing accustoming and without influencing digestion. Phytodrugs on the basis of Senna (Senadum, Tisasen) well are suitable for treatment of the incidental constipations caused by hypotonia and a sluggish vermicular movement of a large intestine for regulation of a chair in hemorrhoids, proctites and anal cracks. It is reasonable to take these drugs for the night as the effect of intake develops not at once, and the chair is normalized after several days of regular reception.
From the synthetic irritating constipation medicine bisacodyl (Dulkolaks, Bisacodyl) is used. At intake in the afternoon its laxative action develops in 6 hours, and before going to bed – in 8-12 hours.
The synthetic irritating constipation medicine with soft laxative action is sodium pikosulfat (Guttalaks, Laksigal, Slabilen).
Drugs of sodium of the pikosulfat do not cause accustoming and can be used is long. Their action also develops within 8-12 hours after reception.
Osmotic drugs (lactulose and macrogoal) at receipt in intestines are not soaked up in blood; their laxative effect is based on increase in content of water in stool, increases in their volume (actually osmotic action) and acceleration of transit on intestines.
Drugs of lactulose (Duphalac) have prebiotic properties, increasing quantity of lactobacilli in a large intestine; it leads to increase in acidity in a gleam of a large intestine and stimulation of a vermicular movement. Effect of lactulose usually has the delayed character – in 24-48 hours after reception that is connected with time of passing of drug through a GIT.
Duphalac is shown for treatment of chronic constipations, regulation of a chair in hemorrhoids, dysbacteriosis and salmonellosis, putrefactive dyspepsia at small children after poisoning.
Other subgroup of osmotic drugs for a constipation form drugs on the basis of a macrogoal of different molecular weight (Tranzipeg, Forlaks, Fortrans, Endofalk). Tranzipeg, for example, has in structure a macrogoal 3350, and Forlaks – a macrogoal 4000. The macrogoal forms hydrogen bindings with water molecules in an intestines gleam that increases liquid content. The laxative effect is shown in 24-48 hours after reception.
Constipation medicine on the basis of a macrogoal applies also to preparation for endoscopic and radiological researches, surgical interventions in a large intestine (Fortrans).
Emollient drugs have mainly auxiliary character in treatment of a constipation and are one of the oldest subgroups. Their effect is based on softening of stool and also on greasing of walls of a rectum that provides sliding and facilitates passing of masses on intestines.
Liquid paraffin has soft laxative effect (on average in 5-6 hours after reception), is well transferred by patients, however this medicine is a little used in pediatric practice as causes flavoring rejection in children.
Candles with glycerin
The emollient effect (softening of stool) which is combined with irritant action (reflex stimulation of a vermicular movement) is provided by candles with glycerin which can be used for treatment of constipations at children of the 1st year of life. After introduction of candles with glycerin the effect lasts 1 hour.