1. General treatment

Constipation patients need to adopt comprehensive treatment according to the severity, cause and type of constipation, including general life treatment, drug treatment, biofeedback training and surgical treatment to recover. Normal defecation physiology. Pay attention to life-style treatment, strengthen education for patients, adopt reasonable eating habits, such as increasing dietary fiber content, increasing water intake to enhance stimulation of the colon, and develop good defecation habits, such as defecation in the morning and defecation in a timely manner when the urge arises. Avoid straining to defecate and increase activity. During treatment, attention should be paid to clearing away excessive feces in the distal rectum; it is necessary to actively adjust the mentality, which are extremely important for effective treatment.

2. Drug treatment

(1) Volume laxatives mainly include soluble cellulose (pectin, plantain, oat bran, etc.) and insoluble fiber (plant fiber, lignin, etc.). Volumetric laxatives have slow onset of action, few side effects, and are safe. Therefore, they are effective in treating pregnancy constipation or mild constipation, but they are not suitable as a rapid laxative treatment for temporary constipation.

(2) Lubricant laxatives can lubricate the intestinal wall, soften stool, make stool easier to excrete, and are easy to use, such as kaiselu, mineral oil or liquid paraffin.

(3) Salt laxatives such as magnesium sulfate and milk of magnesia can cause serious adverse reactions and should be used with caution in clinical practice.

(4) Osmotic laxatives Commonly used drugs include lactulose, sorbitol, polyethylene glycol 4000, etc. It is suitable for fecal impaction or as a temporary treatment measure for chronic constipation. It is a better choice for constipation patients who have poor response to volumetric laxatives.

(5) Stimulant laxatives include plant-based laxatives containing anthraquinones (rhubarb, buckthorn bark, senna, aloe vera), phenolphthalein, castor oil, diesterol, etc. Stimulant laxatives should be used only when volume laxatives and salt laxatives are ineffective. Some are relatively strong and not suitable for long-term use. Long-term use of anthraquinone laxatives can cause colon melena or laxative colon, cause atrophy of smooth muscles and damage the intestinal myenteric plexus, which in turn aggravates constipation, which is reversible after drug withdrawal.

(6) Promotility agents Mosapride and itopride have the effect of promoting gastrointestinal motility, and prucabili can selectively act on the colon and can be selected according to the situation.

3. Device assistance

If the feces is hard and stagnated in the rectum near the anus or the patient is old and frail, with poor or lack of defecation power, colon hydrotherapy or cleaning can be used Enema method.

4. Biofeedback therapy

It can be used for constipation patients with rectal, anal and pelvic floor muscle dysfunction, and its long-term efficacy is good. Biofeedback therapy can train patients to relax their pelvic floor muscles during defecation, so that the activities of abdominal muscles and pelvic floor muscles can be coordinated during defecation. For patients with abnormal defecation intention thresholds, attention should be paid to the reconstruction of defecation reflexes and training in adjusting the perception of defecation intention. There are no specific specifications for the training plan, and the training intensity is relatively high, but it is safe and effective. For patients with pelvic floor dysfunction, biofeedback treatment should be preferred over surgery.

5. Cognitive therapy

Patients with severe constipation often have symptoms of psychological factors or disorders such as anxiety or even depression. Cognitive therapy should be given to patients to eliminate tension and be given if necessary. Anti-depressant and anti-anxiety treatment, and ask a psychologist to assist in diagnosis and treatment.

6. Surgical treatment

All the above-mentioned treatments are ineffective for severe and refractory constipation. If you have constipation with colonic transmission dysfunction and the condition is serious, surgical treatment can be considered, but the distance of surgery is long. The efficacy is still controversial, and cases must be selected carefully. Among the huge disease group of constipation, only a very small number of people actually need surgical treatment.