Constipation (ICD-10 code K59.0)

Definition:

Constipation is a medical condition characterized by reduced bowel movements, posing a gastrointestinal health issue. Treatment for this condition is typically managed by healthcare professionals.

Overview:
Constipation manifests as a temporary or chronic disruption in the bowel movement process, making it difficult to fully evacuate the bowels. Constipation resulting from psychological stress or medication side effects is unfavorable. The diagnostic criterion involves the absence of bowel movements for 48-72 hours, during which the patient may experience strong urges to defecate, abdominal pain, and a general sense of fatigue. Severe straining often fails to alleviate the situation and may be accompanied by the passage of hard, pellet-like stool without complete bowel evacuation. Anal fissures, toxic megacolon, and hemorrhoid formation are among the complications associated with constipation. It is a common disorder in the digestive system, with elderly individuals primarily affected. Primary treatment focuses on improving nutrition, with medication used when necessary.

Symptoms of Constipation:

Symptoms of constipation depend on the underlying cause. The absence of bowel movements for three consecutive days or regular occurrence is indicative. Accumulation of stool in the large intestines leads to intense fluid absorption, stool hardening, and toxin leakage into the bloodstream. Hard stool damages the intestinal mucous membrane, and harmful substances adversely affect the patient’s condition.
Other symptoms and signs include:

1. Feeling of heaviness in the abdomen.
2. Passing hard, black, or dark brown stool pellets.
3. Abdominal pain in the form of cramps.
4. Strong and difficult urges to defecate.
5. Continuous straining to empty the bowels.
6. Large amounts of mucus secretion with hard stool.
7. Feeling of incomplete bowel evacuation.
8. Abdominal bloating.
9. Loss of appetite.
10. Continuous belching.
11. Weakness and fatigue.
12. Sleep disturbances.
    Delayed bowel movement negatively affects the balance of bacteria in the intestines, leading to increased gas production. The presence of blood in hard stool may indicate damage to the intestinal mucous membrane.

Causes of Constipation

The activity of the digestive system directly depends on an individual’s lifestyle. To form normal stool and facilitate bowel movement, the digestive system requires an adequate amount of fiber, which is found in many fruits and vegetables. Specific diets can lead to chronic constipation and the formation of hard stool. Additionally, insufficient physical activity, chronic stress, sleep disturbances, and inadequate water intake are risk factors for constipation. In some cases, constipation may occur even with a healthy lifestyle due to an underlying medical condition.

Other Causes:

• Irritable Bowel Syndrome (IBS): A condition characterized by alternating bowel functions, where patients may experience periods of constipation followed by periods of diarrhea.
• Impaction of Food in the Intestines: Resulting from tumor growth, foreign body impaction, parasitic infection, obstruction, or other abnormal conditions.
• Disruption of Intestinal Movement: The movement of stool in the intestines relies on wave-like muscle contractions. Any disruption in the rhythmic muscle activity of the intestines can lead to constipation.
• Neurological Disorders: Intestinal functions rely on neurological regulation, so disorders affecting the spinal cord and peripheral nerves can disrupt the defecation process.
• Psychological Factors: Psychological stress and anxiety can contribute to constipation.

The effectiveness of constipation treatment largely depends on successful diagnosis to identify the underlying cause of the condition.

Diagnosis at “SM-Clinic”

A comprehensive consultation is conducted by the physician, where the patient’s complaints are detailed, and their medical history is reviewed. Identifying the frequency of bowel movement delays in the patient and ruling out the possibility of intestinal obstruction requires urgent treatment.

The following diagnostic methods are used at “SM-Clinic”:

1. Barium Enema (Radiographic Imaging with Endoscopy): A colored solution is injected into the patient’s intestines via a rectal injection, followed by real-time radiographic examination of the intestines. This examination helps clarify the cause of constipation and rule out intestinal obstruction.
2. Colonoscopy (Colon Examination with Endoscopy): The physician inserts a flexible tube equipped with a camera and light source into the rectum. During the examination, the physician studies the characteristics of the colon’s contents and its mucous membrane condition, under anesthesia to avoid any discomfort.
3. Rectal Pressure Measurement (Anorectal Manometry): This test evaluates the tension of the intestinal muscles and the strength of the muscles surrounding the rectum.
4. Defecation Imaging (Monitoring Defecation Process using Magnetic Resonance Imaging): This detailed diagnostic method enables the physician to evaluate the pelvic floor muscle function and defecation process comprehensively.

Treatment of Constipation at “SM-Clinic”

After diagnosis, our clinic’s physicians select a treatment plan aimed at eliminating the underlying cause of the dysfunction and restoring bowel activity balance. A special diet is prescribed to restore bowel movement and proper stool formation. In cases of mechanical obstruction or other serious conditions, urgent treatment is administered.

Treatment methods for constipation at “SM-Clinic” include:

1. Fiber-containing Medications: Such as Metamucil or any other medication that rebalances stool formation and facilitates defecation.
2. Use of Bowel Movement Stimulating Medications: Short-term use of Bisacodyl or any other medication to improve bowel movement.
3. Use of Liquid Bowel Softeners: Such as lactulose, magnesium hydroxide, or magnesium citrate to remove excess water absorption from the intestinal walls.
4. Use of Stool Softeners: Using sodium docusate or any other medication to reduce water absorption in the large intestines.
5. Use of Rectal Injections and Suppositories: The colon and rectal physician explains how to perform home bowel awakening. The physician also recommends using suppositories containing glycerin or bisacodyl to facilitate defecation.

The primary goal is to improve nutrition and eliminate negative factors from the patient’s daily life, with the physician controlling all stages of treatment to achieve the best results.

Prevention of Constipation

A healthy lifestyle can help prevent the development of constipation or any other intestinal disorder.

Key prevention methods include:

1. Consuming an adequate amount of foods rich in dietary fiber and fats.
2. Drinking at least 2 liters of fluids daily.
3. Engaging in moderate physical activity.
4. Managing stress factors.

Source:

1. Malkov I.S. “Acute Abdomen” // Practical Medicine, No. 8 (47), 2010.