"'' exerts all body strength, but the particles are not harvested"
"If you don't come to the '' after a thousand calls, it's harder than waiting for true love"
This bitterness is only known to constipation sufferers!
Recently, Ms. Zhang, who has been suffering from constipation for a long time, came to the constipation clinic of gastrointestinal surgery of Jiangxi Provincial People's Hospital (the First Affiliated Hospital of Nanchang Medical College) for help, "Doctor, it is difficult for me to relieve a stool once a week, I have no intention of defecation, constipation has been for almost ten years, and I have sought treatment in many ways, not only has no effect, but it is getting worse day by day, and there is no movement in oral various laxative drugs, and sometimes I am really afraid of breaking my stomach." "Ms. Zhang, 33, goes to the toilet 7-8 times a day, but she can't have a smooth bowel movement.
According to the patient's account, the deputy chief physician Hong Huazhang asked for a detailed medical history, comprehensively analyzed the patient's examination data, and combined with the physical examination, Hong Huazhang considered the patient to have intestinal functional constipation. Functional constipation (FC) is mainly divided into three types: slow transit constipation (STC), outlet obstructive constipation (OOC) and mixed constipation. Further evaluation of the patient is immediately scheduled for further diagnosis. After examination by barium colonic transit test, the patient was found to have slow-transit constipation.
Ninety-six hours after oral administration of barium, the images showed that the barium remained in the colon and was not excreted
Slow-transit constipation is a disease characterized by slowing down of intestinal transit, mainly due to decreased colonic motility and prolonged colonic transit time, resulting in a decrease in the frequency of bowel movements, dry and hard stools, and difficulty in defecation. When conservative treatments such as medication and physical therapy do not respond and the patient's symptoms seriously affect their lives, surgery may be an effective curative treatment to normalize bowel movements.
After relevant examinations, constipation caused by tumors, outlet obstruction constipation, etc., was ruled out, and after further diagnosis of slow transit constipation, the selection of appropriate surgical methods became the top priority. If there is too much intestinal resection, it is easy to have persistent diarrhea after surgery, and if there is less intestinal resection, the underlying problem cannot be solved, and it is still constipated. After rigorous and meticulous discussion by gastrointestinal surgeons, it was finally decided to remove most of the colon and preserve the patient's ileocecal valve. This surgical method has a low recurrence probability and good effect, and it also retains the "floodgate", which makes diarrhea not easy to occur after surgery. At the same time, considering that traditional surgery is invasive, slow to recover and affects aesthetics, Hong Huazhang's team carefully designed and selected a new minimally invasive solution according to the patient's condition - NOSES total laparoscopic scaling through the natural orifice (vagina) for this total colectomy. It is done by removing the excised specimen through a natural orifice, such as the vagina or rectum, avoiding leaving additional incisions in the abdomen. This surgical method has only a few small incisions, minimal trauma, hidden scars, and short recovery time, thereby shortening the postoperative hospital stay and reducing the patient's medical costs.
Specimens are removed through natural orifice
Ms. Zhang's intestinal tract recovered 3 days after surgery, and on the 4th day, she had spontaneous bowel movements, and the Wexner constipation score dropped from 23 points before surgery to 4 points. The follow-up patients are currently having regular bowel movements 1-2 times a day, smooth bowel movements and normal stool shape, the patients are very satisfied, and express their sincere gratitude to the gastrointestinal surgery team.
Wexner Constipation Scoring System
The Wexner Constipation Scoring System is a quantitative assessment of constipation symptoms, which takes into account multiple dimensions such as defecation frequency, difficulty in defecation, feeling of incomplete defecation, pain, duration of defecation, and frequency of defecation failure. The friends in front of the screen can test themselves, the higher the score, the more serious the constipation.
Constipation is a common digestive problem that affects people all over the world. It refers to a decrease in the frequency of bowel movements, hard or difficult stools, and painful bowel movements, often accompanied by abdominal pain, bloating, and even intestinal obstruction. While constipation is very common, long-term discomfort and inconvenience can have serious negative health effects.
Affect mental health: Long-term constipation may lead to neuropsychiatric symptoms such as nervousness, anxiety, insomnia, forgetfulness, and even mental depression in severe cases.
Aggravation of systemic diseases: A sudden increase in blood pressure during straining to defecate may increase the risk of cardiovascular and cerebrovascular diseases, such as angina, myocardial infarction, intracerebral hemorrhage, and sudden death from stroke.
Aggravation of rectal and anal diseases: Constipation may lead to anorectal diseases such as proctitis, anal fissures, hemorrhoids, colon ulcers, etc., because dry and hard stools may cause irritation and damage to the rectum, forming a vicious circle.
Gastrointestinal disorders: Stool retains in the intestine for too long, which may cause symptoms such as loss of appetite, abdominal distention, belching, and bitter mouth.
Paradoxical diarrhea: In constipation, a small amount of watery stool may flow out of the anus from a hard stool mass, which may be mistaken for diarrhea and is actually a manifestation of constipation.
Sexual disorders and urinary incontinence: Long-term constipation may affect pelvic organ function, leading to sexual disturbances and urinary incontinence.
Increased risk of colorectal cancer: Long-term constipation may lead to retention of carcinogens in the intestine, and long-term use of stimulant laxatives in some patients increases the risk of colorectal cancer.
If you have constipation symptoms that last for a long time, please seek medical attention in time, most patients with constipation can achieve good results through conservative treatment. For severe constipation, in the case of mastering the indications and excluding contraindications, surgical treatment can be selected to solve the "big traffic jam" of the intestine in time and restore the "intestinal through train"!
Strategies to prevent constipation
1. The key to preventing constipation is to maintain a healthy lifestyle:
Increase dietary fiber intake.
Whole grains: such as oats, barley, buckwheat, corn and other coarse grains, their bran is rich in dietary fiber. In addition, brown rice, millet, sorghum rice, etc. are also good choices.
Potatoes: such as sweet potatoes, purple potatoes, potatoes, taro, etc., these foods are rich in dietary fiber and low in calories, which help promote intestinal peristalsis and bowel movements.
Vegetables: spinach, cabbage, leeks, celery, bamboo shoots, peppers, cauliflower, fungus, shiitake mushrooms, etc. are all vegetables rich in dietary fiber. Not only are they high in dietary fiber, but they also contain a variety of nutrients that help promote good health.
Legumes: Soybeans, black beans, mung beans, adzuki beans, peas, green beans, kidney beans and other legumes are rich in dietary fiber. When making rice or pasta, you can add some legumes in moderation, such as mung bean rice, red bean bread, etc., to increase the intake of dietary fiber.
Fruits: Apples, pears, bananas, peaches and other fruits are also rich in dietary fiber. Although they are high in sugar, they can provide a variety of nutrients to the body when consumed in moderation.
It is worth noting that although dietary fiber is good, some patients with constipation can aggravate discomfort such as bloating, abdominal pain and bowel sounds due to excessive intake of insoluble dietary fiber at one time, which may be caused by increased intestinal gas production caused by dietary fiber. Increasing water intake can enhance the role of dietary fiber in improving constipation symptoms.
2. According to the recommendation of the World Health Organization and the Chinese Nutrition Society
The daily intake of dietary fiber should be 25-30 grams.
Drink plenty of water: Maintain adequate water intake to help soften stool, it is recommended to drink 1500-2000ml of water per day.
Regular exercise: Increase physical activity and promote intestinal peristalsis.
Regular bowel movements: Try to go to the toilet in a timely manner when you feel the need and don't ignore your body's signals. Develop regular bowel habits, fixed bowel movements are better than chaotic bowel movements, and squatting bowel movements help to pass stool, but it is easy to aggravate diseases such as hemorrhoids.
Feeling happy: Getting enough sleep and feeling good can also help relieve constipation symptoms.
Conservative treatment strategies for constipation
1. Laxative drugs: including various laxatives, prokinetic agents and secretagogues. Among them, the most widely used are laxatives, including volumetric laxatives, osmotic laxatives, and irritating laxatives. (1) Bulk laxatives play a laxative role by retaining water in feces, increasing fecal water content and fecal volume, and commonly used drugs include psyllium, polycarbophil calcium and wheat bran. (2) Osmotic laxatives can form a hypertonic state in the intestine, increase the volume of feces, and stimulate intestinal peristalsis, mainly including polyethylene glycol and sugars that are not absorbed (such as lactulose). (3) Stimulant laxatives include anthraquinones such as bisacodyl, rhubarb, castor oil, senna and phenolphthalein, which can enhance intestinal motility and stimulate intestinal secretion, and long-term use can cause adverse reactions such as drug dependence, malabsorption and electrolyte disorders, intestinal melanosis, etc., increasing the risk of cancer, and long-term use is not recommended.
2. Intestinal microbiome treatment: intestinal microecology plays an important role in maintaining the normal physiological function of the host intestine, regulating the body's immune function, and antagonizing the colonization of pathogenic microorganisms. Compared with healthy people, patients with functional constipation have significant differences in the number and variety of intestinal microbiota composition, especially Lactobacillus and Bifidobacteria. Supplementing intestinal microbial preparations, such as Bifidobacterium quadruple viable tablets and Bacillus subtilis triple viable preparations, can regulate gastrointestinal flora imbalance and improve gastrointestinal motility, which is currently recommended as a long-term adjuvant drug for chronic constipation. For patients who have been treated with probiotics for a long time, the oral dose can be increased appropriately.
3. Sacral nerve modulation: The abnormal sacral nerve reflex arc can be intervened through an external pulse generator, and then the dysfunction of the sacral nerve effector organ can be regulated.
Although constipation is embarrassing, it can be alleviated or even cured with the right approach. Remember, keeping your gut healthy is the first step to keeping your whole body healthy. If the problem of intestinal "traffic jam" persists, do not hesitate to seek the help of a medical professional in time.
The Department of Gastrointestinal Surgery of Jiangxi Provincial People's Hospital has set up a special outpatient clinic for gastroesophageal reflux and constipation, which is convenient and beneficial to the people, and can provide professional, standardized and individualized solutions for the majority of patients.
Expert Profile
Hong Huazhang
Deputy Chief Physician
Professionally good at
Diagnosis and treatment of common and difficult diseases in general surgery, especially laparoscopic minimally invasive surgery for gastrointestinal tumors and abdominal wall hernias. In Germany, students studied the application of surgical robots in abdominal surgery. The hospital took the lead in introducing new technologies such as TST, RPH, STARR, LVR, and copper ion chemistry to treat hemorrhoids and rectal prolapse. It has been deeply studied in gastrointestinal tumors, abdominal hernia, gastroesophageal reflux, constipation, complex anal fistula, perirectal abscess, necrotizing fasciitis, hidradenitis suppurativa, pelvic floor tumors, pilonidal sinuses, rectovaginal fistula and other diseases.
Yuan Xihong
Deputy Director of the Outpatient Department
Chief physician
Professionally good at
Routine and day care for common and difficult diseases in general surgery. It is the first in the province to introduce and carry out transanal endoscopic anus-preserving surgery (TaTME) for low rectal cancer, and has deep knowledge in the minimally invasive surgery of benign and malignant diseases of anorectal surgery such as colorectal tumors, rectal prolapse, hemorrhoids, anal fistulas and perianal abscesses, as well as various abdominal wall hernias and inguinal hernias.
Huang Zuoxi
Professionally good at
Diagnosis and treatment of common diseases in gastrointestinal surgery, diagnosis and treatment of common anorectal diseases, etc.
Author: Huang Zuoxi, Department of Gastrointestinal Surgery, Jiangxi Provincial People's Hospital (First Affiliated Hospital of Nanchang Medical College).
Correspondent: Le Xiwen Luo Shan
Editor: Huang Menglin
Reviewer: Chen Shirui
Issued: Daley Red
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