Atonic constipation

Many people have encountered the problem of going to the toilet "for a big one", but if this is an isolated case, then there is no need to worry, it is worse when constipation bothers a person constantly and becomes the norm for him. Most often, women suffer from this ailment, although men have not bypassed this fate. Mostly, doctors diagnose atonic constipation in patients who have come with such a problem.

This pathology indicates that the problem is related to the inability of the intestinal muscle tissues to do their job. Their strength decreases - this leads to weakening of the colon peristalsis. It is this disruption in the digestive system that leads the human body to constipation.

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Causes of atonic constipation

To effectively combat the problem, it is necessary, first of all, to know the causes of atonic constipation. This is the only way to effectively influence the patient's body, expecting an adequate response from it.

• Very often, this disease occurs in people who, due to their character or professional activities, have to lead a sedentary lifestyle. It is hypodynamia that can provoke weakening of smooth muscles. To make it clearer, it is worth imagining a person after a long illness, during which he had to spend a long time in bed. During the recovery process, he has to learn to walk again, since the muscles have weakened, and they simply do not have the strength to carry such a load as the body. Similar processes occur with the intestinal muscles, because during walking, a person strains many different muscle groups, forcing them to work. This also includes the smooth muscles of the large intestine, which move feces to the exit from the anus. If a person does not have problems with intestinal peristalsis, then the process of defecation usually happens once or twice a day. Whereas in a problematic intestine, this process can occur once every two or three days, or even less often. At the same time, a lot of feces accumulates in the intestine, which leads to discomfort.
• The second most important cause of atonic constipation is an alimentary symptom. That is, the root cause of the pathology lies in the food products that often make up a person's menu. If he prefers fast food, a monotonous diet, which mainly includes flour products and meat dishes, does not particularly care that his diet contains a sufficient amount of plant foods, then it is not surprising that he is bothered by constipation. After all, such food is devoid of natural irritants that, acting on the receptors of the intestinal mucosa, force them to contract.
• The diet itself also influences the occurrence of atonic constipation. If a person is used to eating on the go, snacking and eating a full meal only once a day, such an approach to their health will not lead to anything good.
• High levels of lime in the water a person drinks can also cause fecal impaction.
• Atonic constipation can also be caused by the small amount of fluid that the patient consumes throughout the day.
• If people with this problem begin to abuse cleansing enemas, as well as decoctions or preparations with a laxative effect, the nerve endings on the intestinal mucosa, under the constant influence of the irritant, begin to deplete, which invariably leads to a decrease in the tone of the walls and problems with defecation. In this case, doctors talk about "lazy bowel syndrome."
• This pathology can also develop as a consequence of an inflammatory process occurring in the patient’s body.
• Severe physical exhaustion of the body can also lead to this disease.
• Atonic constipation can also be caused by ulcerative or erosive lesions of the mucous membrane of the gastrointestinal tract.
• Our body is a unique product of nature, in which all the functioning of systems and organs is interconnected. A small failure in one link of this complex is enough to start a chain reaction of disorders throughout the body. Therefore, problems with defecation can also occur as a result of a stressful situation in which a person finds himself by chance.
• Prolonged psycho-emotional stress.
• Atonic constipation can also be caused by damage to the body by toxic substances.
• This problem can occur with large volumes of lost fluid: if it mainly comes out through the mucous membrane and skin of a person. This can happen when the affected person is sick and the disease occurs with a high temperature, as well as in the hot season.
• Excess body weight can also provoke atonic constipation.
• A woman may have problems with bowel movements during pregnancy, as well as immediately after childbirth.
• A similar problem can be caused by the onset of menopause in a woman.
• This may be a consequence of surgery affecting the digestive system.
• There are also endocrine causes of this pathology, provoked by a decrease in the function of the pituitary gland, thyroid gland, and ovaries.
• Drug treatment is the use of certain groups of drugs.

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Symptoms of atonic constipation

If a person has periodic problems with defecation, then the symptoms of atonic constipation correspond to the manifestations of the general condition of the body with this pathology:

• Quite a lot of feces accumulates in the large intestine, which is why the intestine has to stretch to accommodate all these masses. At the same time, they begin to press on nearby organs and systems, causing discomfort and pain symptoms in the lower abdomen.
• Bowel movements occur once every two days, or even less often.
• The patient has to exert increased effort (strain) to make the defecation process occur.
• The feces become quite dense in structure.
• A person begins to feel as if he is being burst apart from the inside.
• The general condition of the patient's body worsens.
• A person loses his appetite, and even his favorite food cannot bring it back.
• Signs of intoxication of the body may appear: changes in skin color, nausea, increased body temperature, and others.
• When stool passes, streaks of blood may appear in its composition.

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Atonic and spastic constipation

When a patient has problematic defecation, proctologists divide this problem into atonic and spastic constipation. These types of this pathology have significant differences. The signs of atonic constipation include:

• Large volumes of feces.
• Mostly, during defecation, a large amount of very dense structures comes out at first, while the last portions of feces have a normal density.
• With this type of problem, pain in the lower abdomen is observed, and in order to go “to the toilet” one has to make a lot of effort.
• When feces accumulate in the intestines, they swell, forming large-diameter sausages. When they come out, cracks and ruptures in the anus mucosa are very common, which leads to the appearance of scarlet blood inclusions in the feces.

Whereas spastic constipation manifests itself:

• The feces come out in fragments, representing small separate structures.
• The patient suffers from increased gas production.
• There is a feeling of distension inside the abdomen.
• The pain symptoms are spastic in nature.
• Decreased overall tone of the body. The person feels constant fatigue.
• When a patient undergoes an X-ray, the radiologist can observe the slow movement of feces in the intestines.

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Atonic constipation in a child

After the baby starts to be introduced to complementary foods, and subsequently when he switches to the adult menu, atonic constipation can be observed in the child. Problems with the baby's bowel movements worry his parents. But we should not forget that the digestive system of children of this age is not yet perfect and is extremely sensitive. It can be upset by both external factors: a stressful situation, a change in the environment, a daily routine. And internal ones: a change in diet, illness.

Atonic constipation is most often diagnosed in children, in which defecation occurs once every two to three days, or even less frequently. Fecal matter accumulates, becomes denser, and the baby experiences constant urges to empty the bowels. Unfortunately, defecation in such conditions is very difficult, since initially a very dense "plug" of feces comes out and only then the baby can poop more freely (the subsequent portion of feces is of normal consistency).

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Atonic constipation in infants

Problems with bowel movements bother not only adults, constipation often affects newborns and breastfed babies. If a child under three years of age has frequent constipation, then their cause mainly lies in the area of pathological changes or imperfections of the child's digestive system. The gastrointestinal tract is only just forming, so atonic constipation in infants is not uncommon.

If a child under three months has a bowel movement less than once or twice a day, or if children under three years of age who are being fed complementary foods have a bowel movement less than once a day, you should not panic, but you should not ignore the problem either. The right thing to do in such a situation is to consult a pediatrician, since in addition to problems with bowel movements, the baby may lose appetite and have abdominal pain, become capricious, and have trouble sleeping.

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Diagnosis of atonic constipation

In order to prescribe adequate treatment, the doctor should correctly assess the type of problem. Therefore, the diagnosis of atonic constipation consists of several specific stages.

• Analysis of patient complaints.
• Visual assessment by the doctor of the appearance of feces. This factor will allow to differentiate what type of pathology the disease belongs to: atonic or spastic.
• With atonic constipation, feces are dark in color and come out of the anus in large masses.
• In this case, initially denser feces are released, and then their consistency becomes more liquid.

When diagnosing atonic constipation, it is very important to determine the primary source of pathological discomfort in the body. Only by finding the cause can we talk about adequate and effective treatment.

Treatment of atonic constipation

It is possible to develop an effective treatment protocol only by correctly identifying the root cause of the pathology. But still, the first thing that determines the treatment of atonic constipation is the correction of nutrition and the introduction of a supportive diet, which is based on the patient's intake of a sufficient amount of plant foods with coarse fiber, which helps to "start the work of the intestines."

If atonic constipation affects a baby, then pureed and liquid dishes should predominate in his menu. They will help the intestines to recover.

In this case, you should develop a schedule for eating and defecation, and try to strictly adhere to it.

Gymnastics with specially selected exercises has a positive effect on strengthening the abdominal muscles. Light abdominal massages are very effective for small children.

If such measures do not bring a therapeutic effect, then the attending physician will initiate drug treatment.

To stimulate intestinal peristalsis, drugs from the group of anticholinesterase drugs are prescribed: itomed, peristil, ganaton, proserin darnitsa (tablets) or 0.05% injection solution, kalimin 60 N, koordinax, montana and others.

Peristil in 0.05% solution is administered to an adult patient subcutaneously at 0.5 mg or 1.0 ml once or twice during the day. For children, the recommended dosage is 0.05 mg per year of the little patient's life, but this amount should not exceed 0.75 ml.

When taking the medicine orally, a single dose is 0.015 g, administered to the patient two to three times a day. The maximum daily dosage should not exceed 0.05 g. The duration of treatment is 25–30 days. If medically necessary, the course of treatment can be repeated after a three to four week break.

Contraindications to the drug include the patient's tendency to epileptic seizures, increased sensitivity of the body to the components of the peristil, bronchial asthma, in the case of hyperkinesis (twitching of the entire muscle group), atherosclerosis and heart rhythm disturbances.

If the problem of defecation is accompanied by painful symptoms, then antispasmodics are introduced into the patient's treatment protocol. This may be spazmalgon, spazmalgin, pentalgin, drotaverine, spazmalin, maxigan, bralangin, papaverine hydrochloride, no-shpa forte, linkas and others.

Spazmalgon is administered to the patient intramuscularly, 2-5 ml two to three times a day. Before opening the ampoule, it must be slightly warmed in the palms. The duration of therapy is no more than five days. If the pain symptoms do not go away during this time, it is necessary to stop taking the drug and replace it with another analogue. The maximum daily dosage is 10 ml.

When taken in tablet form, adults and adolescents over 15 years of age are prescribed a dose of one to two tablets two to three times a day, but no more than six per day.

For children aged 13 to 15 years, the dosage is one tablet two to three times a day, but no more than three times a day.

For children aged 9 to 13 years, the dosage is half a tablet two to three times a day, but no more than two times a day.

It is not recommended to prescribe Spazmalgon to patients suffering from hypersensitivity to the components of the drug and other drugs of the non-steroidal anti-inflammatory drug group, as well as in case of circulatory system failures, liver and/or kidney dysfunction, decreased tone of the urinary and/or gall bladder, closed-angle glaucoma, intestinal obstruction, suspected surgical pathology.

This drug should be used with great caution if the patient has a history of gastroesophageal reflux disease, gastrointestinal pathology, and also if the patient’s professional activity is associated with working with potentially dangerous mechanisms and driving vehicles.

In case of long-term problems with bowel movements, the attending physician may prescribe laxatives to the patient: isaman, phenolphthalein, isaphenin, castor oil, lisalac, bisadil, regulux and others.

Phenolphthalein is prescribed to adults at 100-200 mg one to three times a day, which corresponds to one to two tablets. If the dose is a single dose, it is better to administer the drug at night.

• For children aged three to four years – 50 mg, one to three doses per day.
• For children aged five to six years – 100 mg, one to three doses per day.
• For children from seven to nine years old - 150 mg, one to three doses per day.
• For teenagers from 10 to 14 years old – 150–200 mg, one to three doses per day.

There are no special contraindications for taking the drug in question, only the age of the small patient is under three years.

But there are also restrictions on the use of laxatives:

• Long-term use of them causes the body to become addicted, and to achieve the same effect, an increasingly higher dosage is required.
• The introduction of drugs of this group over a long period of time leads to changes in the structure of the mucous membrane of the digestive tract, which can provoke the degeneration of its tissues into malignant cells.
• Long-term use leads to loss of electrolytes.
• May provoke an allergic response in the body.
• Their long-term use causes worsening of intestinal motility disorders.

Rectal suppositories may also be prescribed by the doctor. For example, glycerin suppositories, which are inserted into the anus once a day. It is advisable to do this 15-20 minutes after breakfast.

This type of therapy is contraindicated if the patient suffers from hemorrhoids, which at the time of treatment are in the acute stage, if there are wounds in the anus, as well as in the case of inflammatory pathology of the rectum.

Oil enemas or water procedures such as a circulation shower, in which water is supplied at a temperature of 32–34 °C, will also help structure the stool and make it more “transportable”. The duration of the therapeutic course directly depends on the clinical picture of the disease and the sensitivity of the patient’s body to the proposed treatment protocol.

Enema for atonic constipation

Often, one of the points in the treatment protocol is an enema for atonic constipation, but such a procedure should be prescribed and monitored only by the attending physician. Depending on the genesis of pathological discomfort, enemas of various types are prescribed:

• Cleansing - such an enema is carried out with a volume of liquid of one to two liters. To improve the quality of the enema, you can add decoctions of chamomile flowers, oak bark, calendula, natural apple cider vinegar. This procedure will quickly and effectively cleanse the colon and normalize the pH balance in it.
• Oil - it helps soften the feces and improve their movement through the intestines. The volume of the administered drug should not exceed 150 ml, and the administered oil should be warm (temperature 38-39 degrees). The procedure is most effective if it is administered to the patient immediately before going to bed. The cleansing effect appears eight to ten hours after the enema.
• Introduction of hypertonic solution. It can be easily obtained at home. This name hides a saline solution prepared from 100 ml of warm boiled water and one tablespoon of salt. The volume used in the procedure should not exceed 100 ml. Such enemas act as irritants of sensitive receptors of the intestinal mucosa, and also soften feces well.

There are also contraindications to the use of this treatment method and the use of laxatives:

• Contraindications to this therapy include complete intestinal obstruction, acute fever, inflammation of the appendix and other inflammatory processes affecting the abdominal organs.
• It is not recommended to use laxatives for a long time, since during the process of cleansing the intestines, calcium is washed out and there is a misalignment of water-salt metabolism.
• If a medicine with laxative characteristics is taken for a long time, then addiction occurs and larger doses are required to obtain the desired effect. Therefore, periodically, drugs must be replaced with analogues.

In therapeutic measures, the centuries-old experience of traditional medicine is also used:

• In such a situation, a decoction of flax seeds will do. It is advisable to drink this drink immediately before bedtime, together with the seeds. This decoction is taken in case of chronic constipation, but you should not drink it for a very long time - addiction occurs and its effectiveness decreases. You should not consume this product if you have a history of keratitis or cholecystitis.
• To "start" the intestines in the morning, pour warm boiled water into a cup and dissolve a tablespoon of natural honey in it and drink. This remedy should not be taken if a person has a history of cholecystitis or colitis.
• For such a case, you can prepare a compote based on dried apples and cherries. Drink three to four times a day.
• Sauerkraut brine has good laxative properties, especially if you drink half a glass of it, warm, and add a little yeast beforehand.
• A decoction of oats and lingonberries effectively prevents constipation.
• Plum juice and radish juice, which is best drunk warm, work great.
• If you have a sedentary job, kefir will help support peristalsis, preferably if it is a day or two after release, as well as slightly sour milk.
• There is also such a recipe: add ten grams of vegetable oil to a glass of kefir and drink it in small sips in the evening before going to bed.
• Cucumber brine also has laxative properties, but the classic one with spices and seasonings will not work. You should pour cucumbers with water and let them sit in a warm place for at least a month. After it is ready, drink four glasses during the day.
• Carrot juice is suitable for atonic constipation in both adults and children.
• Freshly squeezed beet or spinach juice. They can be drunk either separately or mixed with celery or carrot juice. The drink is taken several times throughout the day.
• If constipation has become chronic, a salad of boiled or baked beets will help to loosen the bowels. Enemas with the juice of this vegetable are also effective.
• Add two teaspoons of dill seeds (pre-grind them) to one and a half glasses of boiling water, then steam. This is the daily amount of liquid that is drunk throughout the day. A similar recipe is suitable for caraway seeds.
• Anise seed tea is also effective for atonic constipation. Pour a tablespoon of the product with just boiled water and leave for 20 minutes, then strain and take a quarter of a glass three to four times a day half an hour before meals.
• You can take freshly squeezed aloe juice (century plant), which is drunk one teaspoon two to three times a day 20 to 30 minutes before meals. The duration of such therapy is from 15 to 30 days.
• If it is difficult to take the bitter juice, it can be sweetened with honey. Place the aloe leaves in the refrigerator for two weeks. This simple method allows for biostimulation of the plant. After this time, juice is obtained from the leaves and natural honey is added to it in a similar proportion. If the beekeeping product has become candied, it should be kept in a water bath for a while until it becomes liquid, but it should not be kept for a long time. At high temperatures, it loses some of its beneficial properties for the human body. The resulting medicine should be stored in a cool place. It is recommended to drink after waking up, on an empty stomach, half a cup at a time. After two days, the dosage can be slightly reduced.
• There is another recipe using these components. Before cutting the aloe leaves, the plant should not be watered for two weeks. Then cut the leaves and get 150 ml of juice. Add 30 g of liquid honey (if it has crystallized, melt it) to the resulting liquid and mix. Keep the finished medicine in a cool place. Drink one tablespoon twice a day with a small amount of water. In the morning, it is advisable to take it on an empty stomach.
• Prepare a mixture of dill seeds (5 g) and crushed licorice root (20 g). Take one tablespoon of the mixture and pour a glass of boiling water over it. Keep it in a water bath for 15 minutes or let it brew, wrapping it well. Take half a glass, which is drunk an hour after a person has eaten.
• The root of the wavy rhubarb has proven itself to be excellent in the treatment of atonic constipation. It can be used for these purposes in any form. The recommended daily dosage is one tablespoon. This can be either a powder form of the medicine, or a syrup or tincture. In small quantities, this product can work as a laxative. Therefore, in this case, it is especially necessary to adhere to the recommended doses. Rhubarb is mainly good for establishing normal bowel movements in children and adolescents. For elderly people, especially if they suffer from persistent constipation, and also have a history of bleeding hemorrhoids, taking this drug is undesirable.
• Wheat bran, taken in the amount of two tablespoons, also works well in such a situation. Combine this amount of product with a glass of freshly boiled milk. Wrap the mixture well and leave for 30-40 minutes. Another option is to boil it for 15 minutes. Take twice a day, in the morning and before bed, half a glass (preferably on an empty stomach). The duration of the therapeutic course is one month, during which it is recommended to practice cleansing enemas once a week.
• Syrup obtained from rowan berries works great. Wash the berries and cover with sugar, place in the sun, leaving it like that for a month. During this time, the berries will release juice, mixing with sugar. You just need to watch it so that it does not start to ferment. Then drain the liquid, squeezing the berries well. Place the syrup in a container, add a little alcohol there - this will protect the medicine from fermentation. The ideal ratio: take 25 ml of alcohol for half a liter of syrup. It is recommended to drink in the morning on an empty stomach.

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Diet for atonic constipation

In case of problems with emptying the stomach, the first thing the attending physician does is to adjust the patient's diet. The diet for atonic constipation is less gentle than is necessary for spastic constipation.

The patient's diet must necessarily include raw fruits and vegetables. These products are rich in dietary fiber such as ballast, cellulose and fiber. They perfectly absorb water and actively irritate the intestinal nerve receptors, which normalizes its peristalsis. Such products as food bran, carrots and apples, as well as rye bread, have an advantage over others in this characteristic.

• It is better to start the day with a vegetable or fruit salad, drink water with honey dissolved in it, vegetable juices and prune compote effectively start the intestines.
• The following are preferred first courses: vegetable and cereal soups (except rice), cold fruit soups, okroshka, beetroot soup, and cabbage soup.
• Meat dishes prepared from lean varieties. Baked and boiled dishes are allowed. Dairy sausages and high-quality boiled sausage can be consumed in moderation.
• Baked or boiled lean fish, as well as seafood dishes, are allowed.
• Fresh, boiled or baked vegetables are great for side dishes. Vegetable recipes based on beets occupy a special place.
• In your diet, you can use crumbly and viscous cereals (especially buckwheat), pasta: both boiled and in the form of casseroles.
• Among legumes, green peas are preferable.
• Almost all fruits and berries, both raw and processed. Especially valuable are sugary berries: figs, melons, apricots. You can also treat yourself to various mousses, compotes, jams, as well as candies made from berries or fruits.
• It is advisable to use eggs only for cooking. But if you really want to, then no more than one per day is acceptable.
• If the patient's body tolerates dairy products normally, they will be quite appropriate on the table of a person suffering from atonic constipation. This can be whole or acidophilus milk, curdled milk, hard and rennet cheeses, one-day or two-day kefir.
• When preparing food, you can use vegetable oil or butter, but do not overuse it.
• All kinds of vegetable, fruit and fruit-vegetable salads are allowed.
• Spinach, other greens and non-acidic sauerkraut are good for normalizing peristalsis.
• As for drinks, you can drink weak teas, fruit juices, and decoctions of wheat bran or rose hips.
• An hour and a half before the main meal, it is advisable to drink a glass of cold carbonated (still water will do) water. This will allow the intestines to start working and prepare them for the food to come in.

In the diet for atonic constipation, fasting days are welcomed, which the patient spends on apples or cabbage only, but eats them in unlimited quantities. This approach to nutrition will not only restore bowel function, but will also contribute to normalizing weight, the main thing is without fanaticism - everything is useful in moderation.

If constipation does not “haunt” a person constantly, but from time to time, you can use one of the recipes suggested below, practicing periodic preventive courses:

• In the morning, a couple of hours before the expected meal, add two level tablespoons of wheat bran to half a liter of boiling water. Let them gain volume, then eat like porridge.
• It is recommended to eat two apples in the morning, without peeling them. The fruit is more useful in this form.
• If a person has “went to the toilet” and the expected relief has not followed, it is advisable to drink half a liter of water with a teaspoon of baking soda dissolved in it on an empty stomach for several days in a row in the morning.
• Onion drops also work well. Just 10 drops taken before meals will help you forget about constipation. To prepare them, peel the onion, chop it finely and fill the container in which the medicine will be infused by 2/3. Pour vodka or alcohol into the container, fill it to the top, and leave it to stand in a warm place for about ten days, you can leave it in direct sunlight.
• A decoction or infusion of rose hips is also effective; you should drink a glass of it before going to bed.
• For chronic constipation, you can drink a little vegetable oil.

Prohibited foods in the case of atonic constipation prevention include:

• Bakery products made from premium flour, including baked goods and puff pastry dishes.
• Smoked food products (meat and fish).
• Eggs (used only for direct cooking).
• Mustard and horseradish.
• Various canned goods.
• Dishes made from white rice and semolina (limit).
• Mushrooms and dishes made from them.
• Hot spices and seasonings.
• Vegetables such as turnips, radishes and horseradish.
• Strong coffee and tea.
• Culinary and animal fats.
• Alcohol.
• Chocolate.
• Various creams.
• Onion and garlic.
• And some others.

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Prevention of atonic constipation

I think no one will argue that prevention of atonic constipation is much better than its treatment.

To prevent the occurrence of this uncomfortable pathology, it is worth following a number of simple rules:

• Lead an active lifestyle. If a person has a sedentary job, it is desirable that he walks to and from work.
• It is necessary to normalize your diet by removing "bad" foods and introducing a sufficient number of dishes that normalize bowel function. There should be at least four main meals, an apple or other fruit is suitable for snacks. Portions should be small, overeating is not recommended.
• It is worth introducing gymnastic exercises into your daily schedule, which will allow you to “pump up” the smooth muscles of the intestines and abdominal muscles.
• Drink enough fluids, in their various forms.
• Remove bad habits from your life: alcohol, drugs, nicotine.
• Try to perform the process of emptying the bowels at approximately the same time, this will allow you to develop a conditioned reflex to defecation.
• The use of any medications with laxative properties, as well as enemas, should only be prescribed by a qualified specialist.
• Take frequent walks before bed and during the day.
• It is necessary to ensure that defecation occurs at least once a day (normally twice in adults, slightly more often in infants), and then maintain the state of the intestines in this form.
• It is worth learning to avoid stressful situations, and if this fails, to cope with them without dwelling on the problem that has arisen.

Atonic constipation causes not only physical and physiological discomfort to the patient, but also affects the psychological state of the person, therefore, prevention of atonic constipation is a very important measure in the fight against this pathological disease, allowing one to maintain a high standard of quality of life for any person.

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Prognosis of atonic constipation

With timely adequate therapy and active preventive measures, the prognosis for atonic constipation is quite favorable.

Constipation is a problem that some people are afraid to share even with their loved ones. But your health is more important, so at the first symptoms of pathology, you should contact a qualified doctor. Only a specialist can diagnose atonic constipation and give quality recommendations and, if necessary, prescribe treatment. Timely adequate measures will allow you to quickly cope with the problem and prevent more serious complications.

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