Chronic constipation in adults, ICD-10 code, problems, diagnosis, consequences of the syndrome

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Chronic constipation is a condition in which there are disturbances in the formation of stool and difficulty in moving them inside the intestine. By itself this syndrome is not a disease, but a condition that can arise for various reasons. In the International Classification of Diseases 10 revision( ICD-10), it is listed in the section that lists diseases of the digestive system( Class 11).Code of chronic constipation according to ICD-10 K59.0.In order to understand the mechanisms of the formation of chronic constipation in adults and its consequences, it is important to understand some of the anatomical features of the intestinal tract.

The entire human intestine is divided into two parts: the small and large intestine. The large intestine, in turn, is divided into three divisions:

1. The initial department( proximal).
2. Distal department.
3. Rectum( the part closest to the anus).

Each department has its own functions. In the proximal part, for example, up to two liters of liquid feces come in, in the initial section, its contents are thoroughly mixed, most of the water and salts are absorbed here, then a homogeneous pulp enters the distal department, there is intensive absorption of useful trace elements,preparing them to be brought out. When the stool enters the rectum, it literally stretches its walls, stretching affects certain nerve endings that are in the rectal mucosa. They include the processes of defecation, which push the formed feces outwards. With age, the nerve receptors lose their sensitivity. In order to start the process of defecation, you need more stretching of the rectum. But this anatomical feature is not the cause of chronic constipation in adults.

There are two types of constipation: situational and chronic. Situational( or episodic) constipation occurs when the life situation around a person changes dramatically and the body is forced to adapt sharply to the proposed conditions. This can be pregnancy, short-term stress, travel, repair in the house, travel. Situational delays of the stool pass as soon as a person returns to his usual lifestyle. Such conditions are not considered pathological.

Unlike situational, hr.constipation is determined when there is a regular stool delay for 48 hours and longer. The feces stand out, but it's small and it's completely dry. In this case, a person after defecation does not feel relief. Most often, chronic constipation in an adult is a consequence of digestive system disorders, proctologic diseases. Factors that can provoke the formation of feces, a few. We list the most basic of them.

Causes of chronic constipation

Different factors can disrupt motor-evacuation functions of the intestine. These are:

• Neurogenic disorders. Any malfunction in the functioning of the vegetative system is often accompanied by the described symptom. Various nervous shocks, constant situations associated with insoluble conflicts, protracted depression, pathological fears - all this can provoke the appearance of pathology.
• Diseases of internal organs that are capable of changing the hormonal background. This phenomenon is also able to inhibit intestinal peristalsis.
• Vascular diseases that cause circulatory disorders of the circulatory system of the intestine.
• Hypodinamy is the most common cause of chronic constipation syndrome in adults.
• Improper diet - the absence in the daily diet of products containing coarse fiber.
• Violation of drinking regimen.
• Prolonged use of certain medicines. It is noted that the use of Atropine, anticonvulsant drugs, tablets, which contain hydrocarbonate, psychotropic drugs, diuretics can lead to the appearance of chronic constipation in adults.
• Violations of the habitual rhythm of life.
• Diseases associated with inflammation of the hollow organ.
• Education inside the colon of scars, polyps, malignant tumors.
• Pelvic floor muscle atrophy.

To identify the factors provocating the syndrome in humans, only careful collection of anamnesis helps. The problem of chronic constipation significantly worsens the quality of life of the patient, the disease has a certain social significance, so hr. Constipation in ICD-10 is separated into a separate section. When it appears, you need to seek help from proctologists or gastroenterologists. Doctors diagnose chronic constipation in an adult person, if acts of defecation occur less than three times a week, when emptying occurs with great difficulty. The stool does not come out as a mush, but dense, tuberculate. Denote the most characteristic symptoms.

Symptoms of chronic constipation

Very rarely, chronic constipation in adults is the only manifestation of a general malaise. Since the described state is not an independent disease, chronic constipation almost always accompanies other pathologies. Each of us has his own biological rhythm, which sets the frequency of defecation. The rule is considered to be defecation once a day, it is desirable that it occurs at the same time. Constipation in an adult is considered a phenomenon in which:

• Emptying of the intestine occurs every three days.
• The act of defecation occurs with a pronounced stress.
• Cal has a very dense consistency, similar in shape to the fruit of the beans.
• Stool retention is accompanied by pain in the abdomen, a feeling of heaviness, a decrease in appetite.
• An unpleasant odor may appear from the mouth.
• The patient appears oppressed, his functioning, sleep disturbance, other problems decrease.

Classification of chronic constipation

Classification of hr.constipation is associated with etiological factors. If the stools were provoked by choosing the wrong diet, the diagnosis is "alimentary chronic constipation."Neuroreflective factors provoke a neurogenic type of syndrome. Psychogenic delays in defecation are associated with the presence of pathological psychoemotional conditions. There are also proctogenic constipation( motor-evacuation disorders caused by muscle atrophy located in the pelvic floor), iatrogenic stool delays in adults result from prolonged use of certain medications.

In addition, primary and secondary manifestations are distinguished. Primary manifestations are associated with intestinal diseases. In turn, the primary type of syndrome is divided into functional and organic subspecies. Secondary syndrome hr. Constipation occurs because of the development of extraintestinal diseases.

Diagnosis of chronic constipation

To determine chronic constipation in an adult and to prescribe adequate treatment at once it is not possible. To determine the tactics of therapy, a step-by-step study is carried out, consisting of four stages:

• First, an anamnesis is carefully collected, patient complaints are recorded, and a physical examination is performed.
• Radiological examination is then ordered. It allows you to assess how the intestinal peristalsis works, what is the color of the colon, whether or not there is a tumor inside the intestine, whether there is a stretching of the walls of the hollow organ. X-rays show the presence or absence of congenital pathologies.
• If necessary, the doctor can prescribe irrigoscopy - a study that can detect intestinal obstruction.
• The next step is laboratory tests. Depending on the existing preliminary diagnoses, doctors can prescribe and bacteriological tests, carrying out a coprogram that allows to reveal traces of hidden blood. It is important to conduct some laboratory tests, which allow to reveal the functional disorders occurring inside the intestine.

It's not a fact that every patient must undergo all four stages of research. Sometimes it is possible to determine the cause and accurately determine the chronic constipation after an X-ray examination.

Treatment of chronic constipation

The decoding of the ICD-10 code helps to determine the exact regimen for the treatment of chronic constipation. This disease in adults is usually treated with allopathic and homeopathic remedies. The use of laxatives is undesirable. They are appointed only in the most neglected cases. Long-term use of laxative medicines forms another complication - lazy intestine syndrome. Therefore, if there is a possibility, chronic constipation in adults is treated with a diet and adjusting the drinking regime.

Diet for hr. Constipation syndrome is based on the introduction of a large number of foods containing coarse fiber into the diet, on the exclusion of products that contribute to the reduction of intestinal motility. The patient is recommended to strengthen the drinking regime by increasing the amount of liquid to be drunk to 2.5-3 liters. The fractional food is welcome, the regime must be organized in such a way as to exclude the possibility of the formation of long hungry pauses.

If other problems of chronic constipation arise when taking a lot of fruits and vegetables - flatulence, heaviness in the abdomen - symptomatic therapy will be useful, assuming the use of certain medications that can eliminate the concomitant symptomatology.

Cuff blockages are easier to prevent than cure, so if there is a tendency to stool delay, it is important to carry out some preventive measures:

1. Normalize proper nutrition.
2. Drink plenty of fluids.
3. Move a lot.
4. Observe the emptying mode of the intestine.

Possible consequences of chronic constipation

Ignore the presence of the disease can not, otherwise the effects of chronic constipation can be very deplorable. Any problems associated with the described condition, can lead to inflammatory processes in the colon, rectoanal pathologies, stretching of the walls of the large intestine.

But the most dangerous complication is the formation of intestinal obstruction. It can be cured only surgically. In some cases, problems with peristalsis can signal the presence of signs of malignant neoplasms. And this too is very dangerous.

As you can see, it is by no means impossible to ignore chronic constipation. Knowing how to prevent the emergence of dangerous complications, you can try to avoid unwanted complications.