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Untreated constipation favors hemorrhoids and anal fissure

Untreated constipation favors hemorrhoids and anal fissure

Constipation and arrest are the popular names for which constipation (or constipation) is known, a common disorder characterized by persistent difficulty in having a bowel movement.

In general terms, constipation can be defined as the evacuation of very dry, scarce and infrequent stools that occur every 72 hours or more. Difficulty evacuation and feeling of incomplete evacuation may also be part of the intestinal constipation syndrome. It is probably the most frequent gastrointestinal complaint observed in doctors' offices, affecting the woman more. Intestinal constipation may be secondary to a number of causes, including:

  • Low dietary fiber intake
  • Low fluid intake
  • Depression, stress, anxiety
  • Immobility, sedentary lifestyle
  • Travel, change in daily habits
  • Medications such as anticholinergics, antidepressants, opiates, iron, bismuth and anticonvulsants
  • Hypothyroidism
  • Diabetes
  • Pregnancy
  • Scleroderma
  • Retocele
  • Redundancy of the colon
  • Accident Chiropractic Injury
  • Chiropractic Trauma
  • Chagas Disease
  • Hirschprung's Disease
  • Anism (paradoxical contraction of anal sphincter)
  • Colonic inertia (excessively slow colic transit)

Together with the changes in diet, it is necessary to give up physical inactivity and exercise to treat constipation.

Most cases of constipation are resolved by changing eating and living habits. The adoption of a diet rich in fiber (25g / day), with higher consumption of cereals (wheat, oats, maize) and vegetables (vegetables, fruits and fruits), associated with an increase in daily intake of liquids (2 liters of water / day ) will have an impact on constipation. Fibers help little if they are not accompanied by an increase in fluid intake. Nutrition assessment and follow-up are necessary to accelerate and facilitate diet correction.

Along with dietary changes, it is necessary to give up physical inactivity and exercise. It is recommended to aerobic exercise for thirty minutes at least three times a week. It is fundamental that the will to evacuate is respected. Never postpone going to the bathroom if there is a sign that the evacuation reflex may be present. It is also very important to establish a routine for the toilet, for example, always after one of the 3 main meals.

Regarding medications to treat constipation, there are several classes. Osmotic agents (lactulose, magnesium compounds, macrogol, PEG-polyethylene glycol)

  • Irritants (eg, magnesium, macrogol, PEG polyethylene glycol)
  • bisacodyl, phenolphthalein, senne, sacred shell).
  • Most of these products have not been proven effective and well tolerated in the long term, except for lactulose, macrogol and PEG. Fecal-forming agents are ineffective in very constipated patients, and irritatives tend to lead to tolerance (loss of effectiveness) due to the destruction of nerve endings, and cause colic.
  • A new drug is available in Brazil, Prucalopride , which acts as a prokinetic. For those with pelvic floor disorders, such as Anisism (paradoxical contraction of the anal sphincter), the best treatment is Biofeedback, a therapy for the re-education of the body. It is effective in many patients and can be used for long periods. correct parameters. For this disorder, botulinum toxin injection proved to be effective in most cases.

For colonic inertia, as demonstrated by colonic transit time, in the absence of anism and fecal incontinence, in the failure of the drug treatment and after the patient has undergone a psychiatric evaluation, the surgical treatment (subtotal colectomy) may be instituted. associated diseases and factors identified as causal should also be corrected.

Dangers of not treating

Most constipation patients only suffer from unpleasant constipation symptoms such as pain, bloating, cramps,

However, untreated cases may accentuate the formation of colic diverticula (Diverticular Disease) and eventually form fecalomas, a name given to large faecal impaction in the rectum.

The time of onset of these complications is highly variable and individual, and may be very early or take years to occur.

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