Atonic constipation: what is it, the symptoms and treatment

Reducing the frequency of stool with the development of atonic constipation occurs in almost half of the adult population. The identification of contributing factors and the causes of this phenomenon is necessary for its complete elimination. Atonic constipation affects not only the patient's well-being and health in general, but also the quality of life. In addition, this condition can be a symptom of a serious illness, when treatment must be urgently carried out.

What is atonic constipation

This condition develops due to loss of tonus( atony) of the site of the colon. As a result, the progressive wave-like muscular contractions of the intestinal wall are violated, the fecal masses move towards the anal region.

Atony accompanies various diseases in which the smooth muscles of the large intestine are damaged, as well as the nerve endings that ensure the active state of the muscle fibers.

Causes of pathology

Atonic constipation can occur as a result of the development of certain diseases, as well as in violation of the conditions for the normal functioning of the intestine.

The most common pathology occurs as a result:

• of pregnancy and childbirth;
• long-term bed rest;
• decreased motor activity;
• permanent stress and nerve strain;
• eating disorders, large intervals between meals;
• endocrine pathology - diabetes, hypothyroidism, obesity;
• diseases of the nervous system - Parkinson's disease, multiple sclerosis;
• diseases of the digestive tract - chronic colitis, Hirschsprung's disease;
• depressive state;
• uses a range of medications.

Spasmolytics, some antihypertensives( beta-blockers, calcium antagonists), sedatives and antacids containing aluminum are the most likely to reduce the motor function of the intestine. This effect is enhanced by taking several medications at the same time. Therefore it is important, especially with prolonged use, to read the instructions for the specific drug and consult a doctor.

This pathological condition can also develop with the usual suppression of the act of defecation, for example, if it is impossible in the morning to take time to empty the bowel, uncomfortable conditions in the toilet, etc.

Children may have a disability of the bowel, pathological changes in its structure.

Symptoms of

The main symptoms of atonic constipation are changes in the frequency and properties of the stool. For pathology, there are large gaps between bowel movements( defecation): from 2 to 7 days. The volume of feces is large. Consistency can be different and depends on the duration of the intestine. The chair is often soft, but can be in the form of thin, dry, dense sausages.

Characterized by a feeling of discomfort, minor gravity in the abdomen, swelling. Pain more often of moderate or low intensity, but with weakness of the muscles of the pelvis and the abdominal wall, complete absence of pain syndrome is possible. In a number of cases, loss of interest in food is formed.

Clinical signs:

• frequency of bowel evacuation less than 2-3 times per week;
• need to push with considerable effort;
• the duration of strain is more than a quarter of the total time of the act of defecation;
• often use finger assistance for more complete emptying.

The absence of timely cleansing of the body from metabolic products, as well as changes in the microbial spectrum of the intestine, cause common symptoms of intoxication.

Most characteristic:

• general weakness, lethargy,
• reduced performance;
• appetite impairment;
• pallor of the skin;
• periodic increase in body temperature.

For this variant of constipation, the presence of pain in the perineum and the anus is not characteristic. Also after defecation, the patient feels full emptying of the intestine.

When developing in the elderly, atonic constipation has specific symptoms and treatment. They are caused by a natural decrease in peristalsis, a minor pain syndrome and manifestations of general asthenia( weakness, decreased appetite, weight loss), which accompanies many chronic diseases. Such a condition in the patient dictates first of all the need to exclude a malignant tumor.

Diagnosis

When the frequency of defecation, changing the character of the stool, the appearance of unpleasant sensations in the abdomen, it is important to consult a doctor in a timely manner. The main task of diagnostic search is to confirm or exclude an organic disease for which motor disorders of the colon are secondary.

At the examination it is necessary to determine the type of disorder, differentiate the constipation spastic and atonic. This will further determine the tactics of treatment.

The doctor conducts an analysis of complaints, features of the development of the disease, and also examines the patient, probing all parts of the intestine, conducting a finger examination of the rectum.

Instrumental research methods:

1. Recto-manoscopy - endoscopic visualization of the rectum and partially sigmoid large intestine.
2. Irrigoscopy is an X-ray examination method using X-ray contrast medium to detect features of the movement of stool masses through the intestine.
3. Colonoscopy is an endoscopic examination that allows you to see all parts of the large intestine, excluding the rectum.

The studies are carried out in such a sequence that allows to determine as precisely as possible the cause of atonic constipation.

It is also necessary to consult a gynecologist for women and a urologist for men in order to eliminate pelvic pathology, one of the manifestations of which can be constipation.

Special diagnostic methods allow us to identify diseases of endocrine organs, pathology of the nervous system, and dehydration phenomena. In this case, symptomatic treatment of atonic constipation without therapy of the underlying disease is ineffective.

In case of impaired emptying of the rectum, diagnostic methods can additionally be used to assess the functioning of the anal sphincter, the condition of the pelvic floor muscles participating in the defecation act.

Than Atonic Constipation

Atonic constipation develops gradually. In the early stages of its manifestation you can leave it without attention. Therefore, there is a danger of missing a serious illness.

When examining a patient, it is important to identify not only symptoms indicative of constipation, but also signs of possible malignancy.

It is necessary to find out if the patient is not worried about:

• unexplained weight loss( with constant regimen, diet and lifestyle);
• constants, different intensity of abdominal pain;
• pain relief at night;
• periodic or persistent increase in body temperature;
• presence of bloody impurities in the stool;
• pallor of the skin and mucous membranes, general weakness, anemia in the general analysis of blood( decrease in the level of red blood cells and hemoglobin);
• increased leukocyte count and accelerated ESR in the blood;
• enlargement of the liver and spleen;
• the presence of tumor intestinal formations in relatives.

Rare emptying of the intestine leads to a gradual poisoning of the body with metabolic products that were not withdrawn from the body in time. This affects the overall well-being and working capacity.

Delay for a long time of stool in the intestine, where a large number of microorganisms normally exists, contributes to the predominance of putrefactive and fermenting flora over the physiological. Dysbiosis( dysbacteriosis) of the intestine develops. In especially severe cases, these disorders come to the fore in the clinical picture and require specific, including antibacterial, therapy.

Treatment methods

The reason that the patient has had atopic constipation determines the treatment. In addition to the correction of the underlying disease, the therapy uses funds aimed at normalizing intestinal motility.

For atonic constipation prokinetics are used. These are drugs that enhance muscle tone and propulsive activity of all parts of the intestine, including the rectum.

The most widely used:

• domperidone;
• metoclopramide;
• Teopride hydrochloride.

Given the activating effect of bile acids on intestinal motility, choleretic preparations are shown( Allochol, Henolol).

If the therapy is not effective, laxatives are used: senna preparations, rhubarb, lactulose, macrogol. Given the irritating effect and the likelihood of addiction, these medications should be taken with caution.

In the development of complications, in particular - dysbiosis, drug correction is necessary( prebiotic and probiotic drugs).

All medicines can be taken only according to the doctor's prescription, which determines the specific therapeutic agent, its dosage and duration of administration, and also controls the effectiveness of the treatment.

Features of the diet

Therapeutic diet is one of the key components of effective therapy of atonic constipation.

The number of meals should be at least 4 per day. It is important that foodstuffs contain a large amount of fiber, which contributes to the formation of soft feces. It is also necessary to stimulate the motor activity of the intestine with organic acids and sugars, which are contained in fruits.

Must be consumed:

• vegetables - carrot, beet, pumpkin;
• bread from wholemeal, rye and wheat flour, with the addition of bran;
• porridge from buckwheat, pearl barley, oatmeal;
• fruits - figs, dates, dried apricots, prunes, bananas, non-acid apples;
• lactic acid products - fresh kefir, yogurt.

It is advisable once a day, preferably for breakfast, to use 1 tbsp. L.Bran. It is important to gradually increase the amount of fiber, since a large amount of it can cause bloating and the appearance of pain.

Prevention

At the heart of the prevention of atonic constipation is adherence to diet, as well as physical activity, which contribute to regular emptying and effective motor activity of the intestine.

Basic principles:

• maintaining an active lifestyle, moderate physical activity;
• strengthening of abdominal muscles, pelvic floor;
• is sufficient in the diet of vegetables, fruits, water;
• the use of fermented milk products.

In the elderly, periodic examinations are required to monitor the state of the gastrointestinal tract.

Complications

Atonic constipation leads to a number of complications.

The most common are:

• hemorrhoids,
• anal fissures;
• intestinal dysbacteriosis.

The need to strain for release from a large amount of fecal matter causes a gradual increase in the hemorrhoids of the rectum, and failure of muscular protection of the pelvis can lead to the omission of organs( rectum, uterus).

It is also likely the development of secondary immunodeficiency, in which the work of the body's natural defense system against pathogenic agents is disrupted. The risk of colds and other infectious diseases increases, the risk of developing neoplasms increases.

Awareness of the causes of atonic constipation and a clear understanding of what it is, allows you to pay attention in time to changes in the functional activity of the intestine. With further application for medical assistance, a physician can timely reveal the nature of the pathology, determine the prognosis of the disease and the likelihood of complications, which as a result allows saving not only health, but in some cases, the patient's life.

Author: Anna Sanno, doctor,
specially for Moizhivot.ru

Useful video about locks