One of the most socially significant problems are difficulties with bowel movement. This phenomenon occurs in the fact that the act of defecation occurs with great difficulties, slowly and with great interruptions between the acts. The danger of embarrassment is that the accumulated fecal masses disrupt the normal process of blood flow in the vessels of the rectum and contribute to the formation of hemorrhoidal cones. Prolonged delays can be chronic and episodic. Determine the cause of temporary upset of the chair is quite difficult, becauseit can be:
- pregnancy;
- use of certain products, reduced fluid intake and other nutritional factors;
- depression, nervous disorders;
- taking medications, with a side effect;
- tourist constipation, which occurs when violations of the usual regime.
The cause of chronic defecation delays is often the presence of any pathology, in which the delay itself is a secondary sign. When determining constipation, the main factor is the time delay of stool. If within 72 hours of fecal excretion less than three hundred grams, doctors determine the diagnosis of constipation.
Differential diagnosis of constipation
Prolonged interruptions and difficulties in defecation contribute to the development of diseases such as hepatitis, biliary tract diseases due to increased loads on the liver, which can not cope with the intoxication of the body. Complications of constipation with enteritis, secondary inflammation of the colon are complicated. Being a multifactorial disease, the difficult act of defecation can be functional when the character of bowel evacuation and organic is violated. In turn, organic constipation can be divided into the following types:
- Primary, caused by abnormalities in the large intestine.
- Secondary, as a consequence of intestinal diseases, pathological changes in other organs and life support systems.
- Change in motility of the colon with increased etiology.
Differential diagnosis of constipation is intended to determine the cause of hypokinesia of the colon and eliminate the difficulty of defecation caused by dysfunction of the muscles of the pelvic floor. Diff.diagnosis of constipation, includes several stages. Initially, data are collected on the duration of violations in the implementation of the act of defecation, the features of nutrition, the use of medications, which can lead to such violations. In addition, it is necessary to determine the presence of concomitant diseases, the degree of motor activity.
The next stage is the necessary laboratory and instrumental research. Choice of methods diff. The diagnosis of constipation depends on many factors. So a coloscopy, a sigmoidoscopy or an irrigoscopy without fail are appointed or nominated at long constipations at persons is more senior than fifty years. Determination of the diagnosis of violations of the functions of the pelvic floor muscles is revealed in defectography, electromyography, and anorectal manometry. The absence of organic pathologies in studies indicates a diagnosis of IBS or a functional constipation is diagnosed.
When performing differential diagnosis of constipation with symptoms requiring special attention, such anxious signs accompanying stool delay, such as:
- , presence of blood impurities in the stool;
- febrile state;
- weight loss for no apparent reason.
In addition, accelerated ESR, worsening of biochemical and immunological parameters, leukocytosis, anemia, also concern anxiety symptoms. Having established an accurate diagnosis of the underlying disease, if secondary constipation is prescribed, the treatment of this disease is prescribed, while simultaneously adjusting the diet with increasing the content of foods rich in fiber and increasing fluid intake.