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I have scanty loose stools and constipation. Liquid constipation in adults. The main causes of constipation and symptoms

Causes of liquid constipation often much more serious than occasional emptying of hardened stool. Such bowel cleansing may indicate the presence infectious diseases, and even oncology.

Signs of liquid constipation

Normal stool has a soft, shaped consistency, and the process of defecation itself occurs up to twice a day. During a bowel movement, a person does not experience any discomfort and pain, and bowel cleansing occurs easily, without effort and straining.

In the absence of bowel movements for more than a day, we can talk about the presence of constipation. The disease can manifest itself as the release of solid feces, and watery, but with an interval of several days. Observed constipation liquid at any age and, depending on the cause of their occurrence, are accompanied by the following symptoms:

• partial absence of a chair;
• nausea and lack of appetite;
• bloating;
• stomach ache;
• frequent belching;
• fatigue and weakness;
• and joint pain.

Most often, liquid constipation has an alternating etiology: either solid feces, or liquid. Sometimes the ailment is manifested by the release of dense pea-shaped feces mixed with watery or flowing out of liquefied feces at the end of the act of defecation.

The general symptomatology of such constipation depends on the disease that provoked their appearance. Often, irregular bowel movements with watery bowel movements are a sign of serious pathology in the body.

Causes of liquid constipation

There are quite a few factors influencing the development of problematic emptying. If we talk about constipation with hard feces, then most often their appearance is associated with improper diet and a sedentary lifestyle.

If constipation with loose stools, then the reasons for its occurrence are much more serious. The most harmless of them is misapplication, which can be easily corrected by canceling them, in other cases, the cause of the disease may be:

• inflammation in the large or small intestine (enterocolitis);
• intestinal oncology;
• irritable bowel syndrome;
• rectal cancer.

Constipation with loose stools in children

The hardest thing to define liquid, since when breastfeeding, the stool of children always has a liquid consistency. You can guess the problem by the following symptoms:

• no stool for more than 24 hours;
• restless behavior;
• refusal to eat;
• hardening of the abdomen;
• increased formation of gases;
• crying during bowel movements.

Often in children, with poor emptying, yellowing of the skin and rashes, indicating an intoxication of the body, are observed.

Liquid constipation in a child often ends in formation, since the bulk of the thickened feces, through which watery stools seep, does not come out and accumulates in the intestines.

The most common cause of constipation in infants is the mother's malnutrition. Whole cow's milk, which in no case should be given to newborns, can also provoke intestinal problems.

Watery constipation can result from the entry of harmful microorganisms through the mother's milk. If a woman has a history of infectious inflammation, enterocolitis and other ailments, then it is better to transfer the baby to special mixtures.

Treatment and prevention of liquid constipation

Loose stools in babies is treated under the supervision of a pediatrician. If necessary, the child is prescribed drug therapy and transferred to artificial feeding.

The best prevention of watery constipation is to prevent diseases that can affect their occurrence. So, in order to prevent infection with helminths, you should adhere to the rules of personal hygiene and carefully handle food of animal origin.

Proper nutrition, adherence to drinking regimen, strengthening the immune system, avoiding stress and regular physical activity will also help prevent problems with emptying.

Elena Shvedkina on why laxatives are not treated and how to choose the best drug for the buyer

Laxatives are one of the most requested drugs in any pharmacy, and they all belong to over-the-counter drugs, or OTC drugs, that is, they come to the visitors of the pharmacy directly from the hands of the pharmacist, bypassing the doctor. This imposes responsibility on the pharmacist who recommends this or that remedy. What do you need to know about the problem of constipation in order to select and recommend a drug suitable for a particular buyer? Let's figure it out.

Elena Yurievna Shvedkina

endocrinologist, St. Petersburg

What is constipation (obstipatio, constipatio) - prolonged (more than 48 hours) retention of feces in the intestine or insufficient, difficult emptying of the intestines, a feeling of incomplete or prolonged evacuation of feces or hard, dry feces. The frequency of bowel movements in healthy people varies considerably, from three times a day to three times a week. The World Health Organization in the ICD-10 classifies constipation as a disease (code K59.0). Whereas the World Gastroenterology Organization and the American Gastroenterological Association believe that constipation is not a disease, but a symptom... Leading Russian gastroenterologists share their position.

Most people with constipation never seek medical help, therefore, the prevalence of constipation is difficult to calculate. According to the generalized data of population studies, up to 20% of the adult population of developed countries suffers from constipation. Women and the elderly are more likely to develop constipation.

Constipation can be divided into functional (associated with impaired bowel dynamics, " habitual constipation") And organic (associated with persistent narrowing of the intestinal lumen and difficulty in passing feces).

The main causes of constipation can be:

• diet (lack of fiber in the diet and insufficient fluid intake);
• sedentary lifestyle;
• illness gastrointestinal tract(peptic ulcer, chronic pancreatitis, dysbiosis, irritable bowel syndrome, colon tumors, strictures, ischemia, volvulus, diverticula, megacolon and dolichosigma);
• diseases of the anus (anal fissures, hemorrhoids, paraproctitis), accompanied by pain and preventing bowel movement;
• neurological diseases (stroke, spinal cord injury, multiple sclerosis, trauma, Parkinson's disease);
• diseases endocrine system(hypothyroidism, diabetes mellitus, Addison's disease, pheochromocytoma, etc.);
• taking certain medications (atropine, opiates, antidepressants, NSAIDs, antihistamines, calcium channel blockers, and many others);
• depression, anorexia, schizophrenia, and other mental illnesses;
• late pregnancy and early postpartum period.
• Risk factors for constipation:
• age over 55;
• recent surgery on the abdominal or pelvic organs;
• pregnancy;
• limitation of physical activity;
• inadequate diet, it can also cause constipation;
• overweight;
• taking multiple medications, especially in old age;
• uncontrolled use of laxatives;
• terminal stages of diseases, prolonged coma.

In addition to the fact that constipation is often accompanied by a heaviness in the abdomen, flatulence and pain during bowel movements, prolonged constipation leads to dangerous complications such as intestinal obstruction, colon diverticulosis, rectal prolapse, hemorrhoidal bleeding... A terrible complication of prolonged constipation - colon cancer: in case of violation of the evacuation of intestinal contents, carcinogenic compounds that damage the mucous membrane are formed. According to the Central Research Institute of Gastroenterology in 2011, the incidence of colorectal cancer in constipated patients is 4.5%. Constipation itself can often be the first sign of serious neurological (for example, Parkinson's disease), endocrine, gastrointestinal and cancer diseases.

Treatment of constipation primarily boils down to eliminating their causes, normalizing lifestyle and nutrition, physical activity, as well as periodically taking laxatives, but only in cases where other measures are not effective enough!

Role of the doctor and pharmacist

Unfortunately, not only local general practitioners, but also gastroenterologists, for various reasons, cannot always find time at an appointment and tell patients in detail about modern methods of preventing and treating constipation. Therefore, it is pharmacists who should explain to customers that laxatives do not cure, but only relieve the symptom of the disease. However, in most cases, the patient does not even reach the doctor. When the first symptoms appear, people prefer to save time and just go to the pharmacy. The chief patient is more likely to be in contact with the patient than the doctor. Therefore, the pharmacist must know the characteristics of all laxatives, the rules for their administration and contraindications, in order to give individual competent advice to each buyer. In addition, the primary care provider must inform the client that a timely visit to a doctor for chronic constipation will help identify their cause, increase the likelihood of cure and reduce the risk of complications.

Only a doctor will be able to choose the optimal tactics for managing a patient with prolonged constipation. Independent, without consulting a doctor, the patient's prolonged struggle with constipation only complicates the subsequent diagnosis and identification of the root cause.

Algorithm

So, the client-patient, bypassing the doctor, came to the pharmacy, learned that the doctor could make an accurate diagnosis, and still wants a laxative to relieve his torment. What questions should the primary bearer ask before recommending a particular remedy for constipation?

1. Duration of stool absence

   If the stool retention does not exceed 48 hours, laxatives are not required, because this may be a variant of the norm.

   If there is no stool for more than 48 hours, the selection of a laxative is necessary, taking into account the indications and contraindications.

2. Are there any “disturbing” complaints such as:
   • abdominal pain (of any nature);
   • nausea, vomiting, obsessive belching;
   • temperature increase;
   • bloating, delayed gas discharge;
   • weakness;
   • impurities of blood and / or mucus in the feces, traces of blood on toilet paper;
   • black, tarry feces;
   • constipation giving way to loose stools;
   • any sudden changes in the nature of the stool;
   • sharp weight loss.

   Dear pharmacists, remember that if at least one of the symptoms described above joins the "habitual constipation", this is a reason to immediately refer the buyer to a doctor! Delay in this case can be life threatening! The use of laxatives is categorically contraindicated! Indeed, behind the "alarming" symptoms can hide intestinal obstruction, perforation of a stomach or duodenal ulcer, tumors and polyps, squeezing the intestinal lumen, or peritonitis.

3. The presence or absence of pregnancy in a woman?

   During pregnancy, normally progesterone significantly reduces intestinal peristaltic activity, and by more later dates During pregnancy, the growing uterus pushes the bowel loops to the diaphragm, which together can lead to stool retention. As a rule, laxatives are not required for the treatment, everything is decided by the normalization of the diet. In case of persistent constipation in pregnant women, treatment is prescribed by a doctor.

4. Is the patient taking other medications?
   • aluminum-containing antacids;
   • antipsychotics, psychotropic drugs;
   • antidepressants;
   • calcium channel blockers;
   • iron preparations;
   • NSAIDs;
   • opiates.

   All of these drugs can cause constipation. In this case, periodic use of laxatives can be recommended.

5. First time constipation?
   • If constipation is episodic, due to inaccuracies in diet, stress or other factors, a laxative may be recommended.
   • If constipation bothers for a long time, it is necessary to refer the buyer to a doctor for examination.

   Important: if constipation is persistent and requires frequent use of laxatives (every 2-3 days or more), or if laxatives are ineffective, this is a reason to consult a doctor for examination!

6. Has a laxative been taken? If so, which one?
   • If the laxative has not been previously taken, recommend a drug from the laxative group swelling action(see table). These are the drugs of choice at the start of therapy.
   • If a laxative was previously taken, then it should be clarified which one. If drugs from the group of swelling laxatives are ineffective, recommend drugs from the group osmotic laxatives... If the latter are ineffective, a reception is recommended stimulant laxatives(one-time).

   Important: If a buyer again and again turns to a pharmacist for the selection of more and more "strong" laxatives - this is a reason to refer such a buyer to a doctor!

Currently, the following groups of laxatives can be distinguished:

The problem of treating constipation requires the most serious approach. The main key to successful treatment is identifying true reason symptom, which is possible only with a complete examination by a specialist. In this regard, the task of the pharmacist is not only to select the most effective and safe remedy, but also to motivate the buyer to consult a doctor for a detailed examination.

Sources of

1. Bobrov L. L, Circumcised A. G. Propedeutics and private pathology of internal diseases. Textbook for cadets and students of medical training faculties. SPb. 2014.
2. Global practical advice World Gastroenterological Organization. Constipation: A Global Perspective. November 2010.
3. Ivashkin V.T., ed. Rational pharmacotherapy of diseases of the digestive system. Moscow. 2003 r.
4. Svistunov A.A., Osadchuk M.A., Osadchuk A.M., Butorova L.I. Roman criteria for irritable bowel syndrome revision IV (2016): what's new? Clinical medicine.

Violation of defecation occurs with functional disorders of the intestine. Delayed or accelerated evacuation of the contents of the colon is observed against the background of inflammation of the mucous membranes of the digestive tract, disorders of nervous regulation, hormonal imbalance. Constipation after diarrhea occurs after prolonged use of laxatives, antibiotics, and a change in the composition of the intestinal microflora.

Delayed emptying, which was preceded by diarrhea, develops with inflammatory diseases of the gastrointestinal tract, intestinal dysfunction, and weakened peristalsis. An unbalanced diet, bad habits, food or chemical poisoning can provoke a stool disorder. Dyspeptic disorders occur with severe stress, neurosis, unstable psychoemotional state.

The main reasons for the alternation of diarrhea and constipation are:

• improper intake of laxatives, fixing drugs;
• irritable bowel syndrome;
• chronic diseases of the gallbladder;
• acute pancreatitis;
• frequent stress;
• pathology of the thyroid gland;
• inflammatory bowel disease;
• appendicitis;
• hormonal imbalance in women during pregnancy, menopause;
• oncological diseases of the gastrointestinal tract;
• intestinal dysbiosis;
• helminthic invasion;
• long-term use of antibiotics, hormonal drugs;
• transferred operations of the gastrointestinal tract.

In the elderly, those suffering from diabetes mellitus, neuropathies, metabolic disorders, the alternation of diarrhea and constipation develops with gastroparesis. It is a functional stomach disorder characterized by a delay in the evacuation of the food bolus into the small intestine. Prolonged stasis of food leads to a delay in fecal eruption, causes nausea, vomiting, general malaise, vitamin deficiency, and a change in the composition of the intestinal microflora.

Laxative disease after constipation treatment

With the uncontrolled intake of irritating laxatives, a complication in the form of laxative disease can develop. Pathology provokes disorders in the work of the intestines, a violation of the electrolyte, water balance, is characterized by a slow absorption of vitamins from the digested food. Patients suffer from intestinal colic, bloating, burning, itching of the anus. First, there is diarrhea, watery, loose stools, later it is replaced by persistent constipation.

To facilitate bowel movements, patients continue to increase the dosage of laxatives, which further aggravates the situation and can lead to a sharp decrease in blood pressure, changes in heart rate, intestinal melanosis. Delayed bowel movements are exacerbated and difficult to treat.

Irritable Bowel Syndrome Constipation with Diarrhea

IBS is a functional bowel disorder involving stool disturbance, abdominal symptoms without pathological changes in the mucous membranes, and muscle tissue... The disease develops against the background of a violation of the nervous regulation of the digestive tract. Symptoms of malaise appear in stressful situations, after eating irritating food, caffeine, and alcohol. In women, discomfort is observed during menstruation, in menopause.

Read also Constipation treatment for diabetes mellitus 1 and 2 types

Patients suffering from irritable bowel syndrome are diagnosed with abdominal pain of indistinct localization, a change in the consistency of feces, flatulence, and urgency. Emptying occurs less often 3 times a week or more often 3 times a day, constipation alternates with diarrhea. Can be observed "sheep", hard stools, replaced by loose, watery. Feces have bad smell contain mucus.

In addition to the listed symptoms, with IBS, patients complain of chilliness of the extremities, a feeling of "lump in the throat", impaired breathing, panic attacks, and increased anxiety. Psychological and autonomic disorders occur in 30-50% of cases. The disease is often combined with non-ulcer dyspepsia, sexual pathologies, irritable bladder syndrome.

Constipation with diarrhea with enterocolitis

The disease is characterized by inflammation of the small and large intestine, causes atrophic changes in the mucous membranes, disruption of the digestive tract. It develops after severe intoxication, against the background of alcohol abuse, unbalanced nutrition, allergies, viral, bacterial infections of the gastrointestinal tract.

Symptoms of acute enterocolitis:

• diarrhea, loose stools with blood, mucus, lumps of undigested food;
• cramping abdominal pain;
• nausea, vomiting;
• increased body temperature;
• general weakness;
• arthralgia, myalgia;
• the tongue is coated with a white coating;
• bloating, rumbling;
• headache.

Due to indomitable vomiting and diarrhea, dehydration of the body occurs, internal organs, sepsis may develop. With the transition of the disease to chronic form symptoms are less pronounced. An adult is diagnosed with flatulence, dyspeptic disorders, and weight loss. Disturbed by diarrhea and constipation at the same time, bowel movements occur irregularly, accompanied by painful sensations, false desires.

Mental disorders

With neurosis, generalized anxiety disorder, pseudo-ulcer syndrome, intestinal dyskinesia, symptoms of dysfunction of the autonomic, cardiovascular, respiratory system and gastrointestinal tract are observed. Patients experience surges in blood pressure, tachycardia, headaches, psychogenic shortness of breath, insomnia, increased anxiety, fear, diarrhea, or constipation.

In a stressful situation, there is an increased release of hormones, including digestive ones: gastrin, motilin, cholecystokinin. This stimulates intestinal peristalsis, food moves faster through the intestines, excess fluid does not have time to be absorbed, and liquid feces are formed. Psychogenic diarrhea (bear disease) most often develops at the wrong moment, which makes you restrain the urge to defecate, this negatively affects the emotional state of a person. After diarrhea, persistent chronic constipation occurs.

Read also Which doctor treats constipation

Treatment methods

Therapy is carried out symptomatically, taking into account the primary causes of dyspeptic disorders. With stool retention, laxatives are prescribed, diarrhea is treated with fixing agents. Patients need to follow a special diet, give up bad habits. For psychological illnesses, antidepressants, sedatives, and antispasmodics are prescribed.

Acute inflammation is treated with antibiotics, the intestinal microflora is normalized with probiotics, colloidal solutions, vitamins, and antioxidants are infused to restore the electrolyte balance of the blood. Pain syndrome is relieved with anesthetics, defoamers and enterosorbents are prescribed for bloating and distention.

Medicines

If, after constipation, diarrhea occurs, frequent emptying of liquid feces occurs, antidiarrheal drugs help to normalize the stool:

With diarrhea, violation of the composition of microflora, Biolact, Linex, Lactium are used. Patients with inflammatory bowel disease often ask what to do if they develop uncontrollable diarrhea. Such patients are prescribed Salofalk, Asakol. If the upset of the stool is caused by intoxication of the body, it normalizes peristalsis, removes toxins Nifuroxazide, Phtalazol, Entoban, Sorbex.

Laxatives for constipation:

• Picolax.
• Picosene.
• Normase.
• Bisacodyl.

When constipation and diarrhea are worried at the same time, dysbiosis is diagnosed, probiotics are used - Bifidumbacterin, Hilak forte, Biosporin. The drugs are effective for irritable bowel, psychogenic disorders.

Note! If there are contraindications to the use of oral laxatives, you can use rectal suppositories, microclysters and put cleansing enemas with an oil solution.

If you are worried about spastic constipation and diarrhea, intestinal colic, flatulence, antispasmodics help relieve the condition: No-shpa, Spazmalgon. Bloating is reduced by defoamers (Espumisan), enterosorbents (activated carbon, Lactofiltrum), digestive enzymes (Pancreatin, Mezim forte).

Diet change

For chronic constipation, inflammatory bowel diseases, patients are prescribed a special diet (table number 3). The basis of the diet is made up of dishes that stimulate intestinal peristalsis, exclude foods that can cause fermentation and increased gas formation.

Important! In case of constipation or diarrhea, it is necessary to observe the water regime. You should drink at least 1.5 liquids per day.

If the feces are hard, the following foods help to enhance the evacuation function of the intestines with constipation:

• dried fruits - dried apricots, prunes;
• fermented milk products - yogurt, yogurt;
• pears, plums, melons, apricots, peaches;
• buckwheat, wheat groats;
• broccoli, white cabbage;
• pumpkin, tomatoes;
• flax seeds;
• walnuts.

In case of constipation, sweet, rich pastries, pastries, strong coffee, sour fruits and berries, semi-finished products, chocolate are excluded from the diet.

If at first the stool is hard, dense, and then liquid, watery, emptying occurs more than 3 times a day, fixing products are added to the menu. These properties are:

• rice, semolina porridge;
• skim cheese;
• jelly, strong tea;
• pasta;
• unripe bananas, apples;
• fresh white bread;
• quince, blueberry, persimmon;
• sweets, baked goods.

Constipation treatment is painstaking work. The intestine is a very capricious organ.

It is worth overdoing it a little with laxatives and diarrhea replaces constipation, which also needs to be treated. And fixing drugs cause constipation again.

Therefore, it is better to entrust the treatment to a specialist. Constipation affects different age groups of people from newborns to the elderly.

Therefore, you cannot get rid of chronic constipation with strong laxatives - bowel problems and constipation must be treated wisely!

If constipation is caused by errors in nutrition, a sedentary lifestyle or nervous exhaustion, you can cope with it yourself.

If the reason is physical inactivity

With hypodynamia, the intestines rebel against its non-physiological position. Bloating and constipation begins. This problem can be solved simply: every 1.5-2 hours you need to take a break, get up from a chair, walk a little, warm up.

With constant sedentary work, hemorrhoids are often exacerbated, which also leads to impaired bowel movement.

If stress is the cause

Stress can cause bear sickness and constipation - and in the same person. It is customary to “seize” stressful situations with junk food, the microflora of the stomach and the production of digestive enzymes are disturbed, and constipation appears.

In such a situation, you can take "Afobazol", "Persen", "Tenoten". The drugs will help to cope with stress and the stool will return to normal.

If the reason is poor nutrition

More than 35% of constipation is caused by poor diet. This means that there is more fiber, fruits, vegetables, less fast food, salinity, fat and smoked meats, then bowel emptying will occur hourly.

In these cases, you need to enter the normal rhythm of life and the constipation will go away on its own. True, you should not endure more than four days. The feces can become very compacted - this condition will have to be stopped with laxatives.

Treat in the folk way

If, despite preventive measures, it was not possible to get rid of constipation, folk remedies come to the rescue second:

1. First, food is called for help. Beetroot and prune salad, prune compote, fresh kefir, a spoonful of flaxseed oil help to relieve constipation and relieve unpleasant symptoms. Dill, parsley, anise and fennel seeds can relieve flatulence and constipation.
2. To treat bowel problems and constipation, you can prepare the following mixture: pour half a kilogram of prunes with water (about 3 liters), simmer over low heat for 20 minutes. Then cool the broth and add 200 ml of holosas. "Holosas" is a choleretic agent made from rose hips. With the help of this tool, the body removes toxins, improves the properties of bile, liver function, and treats constipation. You need to drink the mixture at night for 1 glass.
3. In the morning on an empty stomach, drink a glass warm water from 1 st. l. honey and 1 tbsp. l. lemon. This drink starts the intestines and cleanses the body of toxins.
4. Taking bran. Bran contains coarse dietary fiber that swells in the stomach and helps move food through the intestines. In the morning, you need to eat a tablespoon of granular bran with plenty of water. Taking bran in the morning will provide the body with fiber, help lower cholesterol and sugar levels, and relieve constipation.
5. Massage for normal bowel function. Every morning, without getting out of bed, press on the hypochondrium on the right side. Then press the acupuncture point located 2 cm below the navel. Do both exercises 7 times.
6. If food products are powerless, you need to purchase a natural laxative. "Fitolax" contains apricot, a small percentage of senna, dill and plantain leaves. Its mild laxative effect develops within 8 hours. You need to chew 2 delicious phytolax tablets at night. Frutolax is also a natural remedy made from prunes and figs. "V. Ogarkov's drops forte №5" are ideal for people with "lazy" intestines, they contain fennel extracts, which are able to relieve flatulence, extracts of aloe, rose hips, nettle and licorice. Licorice contains mucus, which protects the stomach lining from irritation and softens the stool.
7. Flaxseed flour. Flaxseed is ground in a coffee grinder. One tablespoon of ground flax is added in the morning to yogurt or kefir. After a few days of such breakfasts, the stool should return to normal.
8. Reception of microcellulose. She, like flax seeds, bran, refers to bulk intestinal fillers. Such drugs are not absorbed and are difficult to digest, increasing the volume of feces and improving their movement through the intestines. There are downsides to these remedies, and fillers cause bloating and sometimes cramping in the intestines. Bulk laxatives are ineffective for sluggish bowel syndrome and motility disorders. Microcellulose, flax seed and bran are contraindicated in pregnancy and with irritable bowel, they are ineffective in bedridden patients. The use of natural laxatives is considered safe. They can be drunk for a long time. And for people prone to constipation, flaxseed should be included in their daily diet.

Treatment of constipation with drugs

It is advisable to consult with a gastroenterologist before taking medication in order to exclude organic pathology of the digestive system.

Lactulose preparations

The safest are drugs with lactulose. They regulate the rhythm of the bowel. By increasing the volume, the drugs soften the feces. "Normaze", "Lactulose", "Duphalac" will not only get rid of constipation. Lactulose is classified as a prebiotic.

It is a carbohydrate, the distinctive feature of which is that it is not digested in the upper gastrointestinal tract. Therefore, it is able to reach the large intestine in its unchanged form. The drugs increase the production of normal microflora and improve liver function.

For constipation, adults are prescribed 15 ml of lactulose in the morning once... Bowel movements will become regular after three days of taking the remedy.

Sick chronic constipation lactulose preparations can be drunk for a long time. If constipation is episodic, lactulose should be drunk in an amount of 45 ml, and after 8 hours the effect will surely come.

Drugs that can safely treat constipation include inulin and some fructooligosaccharides. These drugs cannot be classified as strong laxatives. But, with long-term treatment, they are able to restore bowel function.

Candles with glycerin

Suppositories with glycerin ("Glycerol", "Glycelax") contain macrogol. He is able to soften stool. Due to filling with liquid, their volume increases. Emptying becomes more comfortable.

Basically, it is used in patients who are contraindicated to strain during the act of defecation - after strokes and heart attacks, during pregnancy and hemorrhoids.

Suppositories with glycerin are contraindicated for rectal tumors, bleeding, exacerbation of proctitis. Method of application: 1 suppository rectally, immediately after breakfast. Long-term use is not recommended, as the process of the natural work of the intestines is disrupted.

Microclysters

"Microlax" - rectal microclysters. Allowed for use in children from 3 years old, elderly patients and pregnant women. Microclysters are administered rectally once. The effect develops within 10 to 30 minutes.

The combination of sodium citrate and sodium lauryl sulfoacetate has an irritating effect on the nerve endings of the intestine and liquefies feces.

These substances are not absorbed into the bloodstream, and are not addictive even with prolonged therapy.

These funds are considered safe. Suitable for all ages. Long-term and chronic constipation can be treated with drugs.

Other medicines

If there is no desire to drink expensive lactulose for a long time, put candles and microclysters (this, most often, concerns men), strong laxatives are used. They have many undesirable effects and are not suitable for long-term treatment constipation and its symptoms.

Magnesium sulfate

Perhaps the most powerful saline laxative. A single dose (20 g) is dissolved in a glass of water. They drink a freshly prepared solution. Effects after about 2 hours.

At this time, do not leave the house. Saline laxatives work powerfully. Magnesia is good for rare constipation.

Applying osmotic agents for several months, you can "earn" cardiovascular failure. The drugs interfere with the absorption of potassium and magnesium - this leads to heart failure.

Prolonged use of saline laxatives is unacceptable in children, since a violation of water-electrolyte metabolism can lead to dehydration.

The sensations after taking magnesium are not pleasant - spasms, bloating, and it tastes very bitter.

Osmotic laxatives are able to retain water in the intestinal lumen. There is a softening of feces.

The drugs increase the volume of intestinal contents and promote comfortable emptying. The drugs raise osmotic pressure by using water from the fatty tissue surrounding the intestines and plasma.

This causes a strong laxative effect of the drugs. The powerful laxative effect of saline agents is used in case of poisoning.

Preparations containing bisacodyl ("Dulcolax")

It can be candles or pills. They help well with hemorrhoids, hypotonic and atonic constipation. If bowel movement is desirable in the morning, take 1-3 tablets of bisacodyl in the evening. The action develops within eight hours.

Side effects include colicky abdominal pain, diarrhea, nausea, rumbling and bloating. The candles take effect after 4 hours.

Bisacodyl is the drug of choice in the treatment of constipation accompanied by hemorrhoids and anal fissures. Apply drugs before endoscopic examination. They are prescribed for various diets.

Long-term use of drugs in this group leads to dehydration and intestinal atony.

Sena preparations

among them are "Senade", "Glaxena", "Senna thick extract", "Senadexin". The initial dose is 1 tablet at night, the effect develops after 8 hours.

If there is no emptying within 8 hours, the dose should be increased to 3 tablets.

Cons of Senna preparations: intestinal colic, flatulence, addiction. Suitable only for relieving symptoms and treating occasional constipation.

Buckthorn bark, joster fruit

Gastroenterologists do not like these drugs due to the lack of strict dosing and quick addiction.

Products containing sodium picosulfate

Among them are "Guttalaks", "Slabilen", "Regulax" and others. Good because they do not cause colic and chronic diarrhea. The drugs "work" at the level of the large intestine, increasing peristalsis.

Macrogol

The pharmacy sells Lavacol, Fortrans, Forlax.

Macrogol is not absorbed into the systemic circulation. It does not cause addiction, disturbances of intestinal motility and dehydration. Therefore, macrogol-containing drugs can be used for up to three months.

Macrogol is well tolerated. It does not cause flatulence, pain, rumbling in the stomach. His work is aimed at softening the feces by increasing the fluid content in them.

The drug is drunk during breakfast by dissolving the sachet in water.

Contraindications to taking laxatives

Laxatives are not recommended for every condition. Some symptoms should alert the patient and force him to refrain from self-medication, and the doctor should take them into account when prescribing therapy. Contraindications include:

• pain and spasms of unexplained etiology;
• acute proctitis;
• stomach, intestinal and uterine bleeding;
• diseases of the gastrointestinal tract in the stage of exacerbation;
• intestinal obstruction;
• entrapment of an inguinal hernia;
• acute cystitis;
• violation of electrolyte metabolism.

Constipation aids

Sometimes constipation is provoked by diseases that are not at all associated with intestinal motility. Then taking laxatives will not give positive result and symptomatic therapy is needed:

1. Constipation can be the result of digestive disorders. In this case, enzymes will come to the rescue: Pancreatin, Festal, Creon, Panzinorm Forte. The drugs improve digestion, ease the work of the pancreas and help relieve constipation. "Festal" contains bile, which improves liver function. And choleretic drugs often have a laxative effect. If large undigested food particles are found in the feces, there is nausea, heaviness in the epigastric region - it's time to drink enzymes. They are prescribed 1-2 tablets (capsules) with each meal.
2. If constipation occurs due to impaired liver function, hepatoprotectors will come to the rescue. "Essentiale Forte", "Essliver Forte" contain phospholipids that restore damaged hepatocytes, the liver begins to cleanse the body of toxins and the stool is normalized. Karsil contains milk thistle extract. Milk thistle is used in the complex treatment of constipation. Liv.52 is a hepatoprotector with a complex of herbs. It has a choleretic effect and helps with constipation.
3. Prebiotics and Probiotics. "Hilak-forte", "Linex", "Acipol" improve the intestinal microflora and treat constipation and diarrhea caused by dysbiosis.

Constipation is often associated with decreased peristalsis. In this case, domperidone preparations are effective. "Motilak",

• "Motilium" - central blockers of dopamine receptors, capable of increasing the tone of the lower alimentary sphincter and peristalsis of the antrum. The drugs relieve flatulence, nausea, vomiting and, improving peristalsis, relieve constipation.
• Trimebutin "Trimedat" is an antispasmodic that helps with disorders associated with impaired gastrointestinal motility, including constipation and diarrhea.
• Castor oil is an ancient laxative. It is used mainly on the eve of diagnostic procedures. Do not use it often (course no more than 3 days) - complications may begin in the form of pancreatitis, nausea, etc.
• Sunflower, olive, pumpkin and others vegetable oils... They "work" by lubricating the feces. Microclysters with oil can be used.

There are many treatments for constipation. The doctor will help you to choose the right one. In any case, preference should be given to safe drugs, which include lactulose.

An even better option is to avoid the condition where constipation becomes chronic. Proper nutrition and sports - will become faithful helpers against constipation.