Constipation is so widespread that it bothers millions of people around the globe that they have become the subject of study of a separate branch of medicine. Most often, the cause of complaints about difficult defecation are diseases of the internal organs, but recently it is increasingly becoming an independent disease.
When constipation is concerned, depending on the causes of the constipation, the list of complaints can be short or extensive. When constipation complaints are on:
- spastic pain before defecation;
- severe pain during defecation;
- discomfort and feeling of overflow of the abdominal cavity;
- phenomenon of flatulence;
- feeling of incompleteness of the act of defecation.
In addition, those suffering from constipation complain of a decrease in appetite, deterioration in overall well-being, headaches, body aches, depression, nervous system disorders, sleep disorders and bad breath.
Constipation examination
If constipation is a chronic condition, then this can be a sign of a variety of diseases. To avoid undesirable complications and successfully cope with difficulties during defecation, you need to see a doctor, describe the complaints and undergo the necessary examination for constipation. Diagnosis includes several stages:
- Clarifying patient complaints, external examination to determine the presence of so-called "signs of anxiety" - weight loss, fever, general weakness, traces of blood near the anus;
- Clinical examination.
- Instrumental diagnostics.
A constipation examination begins with palpation of the abdomen and reveals the presence of hemorrhoids, anal fissures and tumors, prolapse of the rectum. Then laboratory tests are appointed:
- coprogram;
- a clinical blood test of a general nature;
- biochemical blood test to exclude hormonal disorders.
If more detailed examination of the intestine is required for constipation, the doctor prescribes instrumental methods including:
- sigmoidoscopy;
- colonoscopy, irrigoscopy;
- X-ray examination;
- ultrasound diagnostics and computer electrogastroenterography.
How to examine the intestines with constipation?
Prolonged constipation can be caused by depression, when a feeling of extreme fatigue, hypochondria suppresses the urge to defecate. It is also possible food anorexia, when the appearance and smell of food adversely affects peristalsis. Also, when complaints about chronic constipation are carried out psychological testing and are consulted by a psychiatrist. Conducting a rectal examination is that the doctor, inserting a finger into the anus, finds out the condition of the anal sphincter and the contents of the rectum at the exit. A special optical device is examined by the mucous membrane of the sigmoid colon. X-ray of the large intestine with the introduction of a contrast agent( irrigography) is the most modern and most common method of diagnosis in cases of constipation complaints.
This method diagnoses the following:
- inflammatory processes in the intestine;
- congenital abnormalities of development;
- tumors, diverticula, polyps and other anomalies.
This examination reveals the length of time of stool delay along the entire length of the colon, clear or jagged contours in different parts of the organ, alternation of relaxed and spasmodic areas. If the constipation is very long and strong, then an additional examination of the pubic-rectum muscle balloon proctography is prescribed. However, if the cause of stool retention is a functional disorder of the colon, the irrigography is not very effective. In this case, more advanced X-ray methods with high diagnostic ability are used, they are harmless and very informative. It's about computer diagnostics and ultrasound. These methods are used to establish the presence of neoplasms in the ileum, liver or abdominal cavity.
On ultrasound it is possible to examine and visually assess the condition of the walls of the large intestine, pelvic structures and other nearby organs. In differential diagnosis it is possible to conduct histological analyzes of the mucosa by the method of colon biopsy and rectal biopsy. Colon biopsy allows the cultivation of a bacterium, a virus or a microorganism if there is a suspicion of the infectious nature of changes in the mucosa, to establish the cause of prolonged stool delay. When bleeding, this method reveals not only the source, but also determines the cause of the appearance of blood secretions. With the help of special devices, the state of the motor function of the intestine is evaluated, based on the registration of gastrointestinal biopotentials. To assess the state of microflora, in addition to the bacteriological study of stool, use chromatography-spectrometry and analysis of microbial metabolites.