Special selection of constipation in the group of functional diseases of the colon is dictated by the very wide spread isolated delay stool in adults as a long-term (sometimes decades) current illness. Among all diseases of the bowel constipation as a separate functional disease occurs in about 10-12% of patients. In addition, it accompanies most of the large intestine diseases and is often found in the pathology of other organs of digestion.
The leading role in the implementation of defecation nervous system and the significant role of the cerebral cortex necessitate primarily to specify the concept of "constipation". Installed (Berntd et al., 1969), around 70% of healthy adults, the frequency of stools is 5-7 times a week, 26% 1-3 times a day and only 4% - 3-4 times a week. If the chair is more rarely, it should already be regarded as constipation. Accompanied by constipation, as a rule, a sense of incomplete emptying of the bowel and more dense stool consistency.
Often patients are convinced that they have constipation, only on the basis of impressions that "the number of Kala" is not enough that he is denser than it should be, or in connection with the fact that the chair is not daily, and sometimes in a day or two. This so-called "imaginary constipation associated with a certain mental attitude that often leads to unjustified use of laxatives (including salt) and the subsequent development is already true of violation of the act of defecation.
Thus, under constipation as separate functional disease should be understood long impaired bowel movements (stools less 3-4 times a week), accompanied in most cases by a complex of subjective sensations.
The main cause of constipation should be the suppression or reduction of reflex that is associated with the act of defecation. This may be caused by the following factors:
1. Long-lasting power of food, poor waste. In these cases, the number of content coming into the distal colon, much less than usually. There is not sufficient stimulus the side of the vial rectum, causing reflex operation.
2. Suppression of reflex, sometimes associated with reduced anxiety rectum, as a consequence of previous diseases (acute dysentery and other).
3. Mental suppression reflex for defecation is the most common cause, leading to the emergence of constipation associated with frequent change of residence and the usual conditions of life and power (constipation "travel"), the need to restrain the urge to bottom in connection with the profession (operators, vendors, and others), mental fatigue, sedentary lifestyle. As a result of these and many other, not always take into account the reasons the time bowel evacuation slides, which ultimately leads to the development of reduced reflex excitability of the rectum.
These factors, leading to occurrence of constipation, particularly easily implemented in patients prone to nervousness, and in men with a tendency to hypochondria, and women - to hysteria. In this connection it is necessary to think, that these pathological conditions are favourable background for the development of constipation, and not Vice versa, as is often indicated that constipation are responsible for the development of neurotic States. Promotes the development of constipation under the action of these reasons and extended the colon as congenital anomaly.
The clinical picture of constipation different. In some cases there is only one symptom - stool retention without any other unpleasant sensations, except difficulties during defecation and the presence of a mental condition of the patients is associated with a defective function of their intestines. Such a course of constipation is usually observed in the early stages of the disease development. In a number of cases occurs due to the presence of constipation, a number of unpleasant sensations, such as the feeling of bloating, fullness in the abdomen, sometimes even dull pain, belching air, nausea, retching on the bottom, which fails to secure the release of the intestine. Can be observed and General phenomena fatigue, headache, dizziness, insomnia. Patients indicate that all these phenomena are connected with the delay of the chair. After taking a laxative and emptying all of them for a short period to pass. Objective examination may experience bloating and diffuse tenderness to palpation, in some cases it is possible to probe dense (rarely "rough") sigmoid colon is filled with dense feces. After enemas this "density" disappears.
Symptom delay chair easily diagnosed. The main task of diagnosis for constipation is by way of distinguishing a symptom of a delay of the chair is associated with organic lesions of the intestine or diseases of other organs, from the described functional diseases of the colon. Therefore, constipation as a functional disease of the colon can be diagnosed only after a thorough examination of the patient, resulting excluded all other diseases that may be related to the delay of the chair.
Constipation often associated complications. Of them it should be noted hemorrhoids (its occurrence or progression in connection with the development of constipation), sphincteric, proctitis.