Spastic constipation

Bowel function can be disrupted for various reasons. As a rule, its normal emptying is associated with two conditions - atony or spastic constipation. In this article, we will talk about the second option - the occurrence of intestinal spasms, as a result of which constipation develops.

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Causes of spastic constipation

Constipation caused by intestinal spasm occurs as a result of increased intestinal tone.

• In certain sections of the intestine, muscle spasms occur, as a result of which the feces become clamped and lose the ability to move further.
• The spasm is often accompanied by flatulence, spastic pain and a feeling of heaviness and fullness in the abdomen, which is associated with increased gas formation.

Spasm can also occur as a result of endocrine pathology, or under the influence of emotional and mental stress:

• in hypothyroidism;
• in diabetes mellitus;
• in case of ovarian dysfunction (for example, during menopause);
• in diseases of the pituitary gland;
• with irritable bowel syndrome;
• in neurogenic colitis;
• after poisoning.

Most often, the main factor in the development of the disease is a regulatory disorder of the autonomic nervous system.

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Symptoms of spastic constipation

Intestinal spasm is characterized by the delay in defecation occurring not constantly, but periodically. In between constipation episodes, the stool may be normal or even liquefied. Often, situations can be observed that can be compared to a mild form of diarrhea - this is the result of the body's response to prolonged stool stagnation and muscle spasm. In most cases, this occurs when the spasm is associated with nervous disorders.

Clinically, muscular intestinal spasm manifests itself as irritable bowel syndrome, which can be expressed in the following symptoms:

• abdominal pain, often cramping;
• periodic delay in stool;
• the release of mucus particles along with feces;
• increased emotionality and irritability;
• constant feeling of fatigue.

Sometimes the delay in stool may be insignificant, however, the excretion of feces is incomplete, in small elements. After such defecation, there remains a feeling of incomplete bowel emptying, heaviness in the abdomen, unreasonable satiety.

Spastic constipation during pregnancy

70-80% of women complain of problems with defecation during pregnancy, and about 30% in the postpartum period. Atonic constipation associated with inactive intestinal peristalsis is more common at this time. However, intestinal spasms are also not uncommon in pregnant women.

Regarding how to distinguish spastic constipation from atonic constipation, the following can be said:

• intestinal atony is the absence of peristalsis, which may be due to the relaxation of the smooth muscles of the intestines, the lack of fiber in the diet, and other reasons. With atony, the intestines are "silent" and there is no urge to defecate;
• spastic condition of the intestine is usually accompanied by increasing and temporarily relieving pain, rumbling in the stomach, increased gas formation and irregular bowel movements (constipation can be replaced by diarrhea).

What causes constipation:

• The longer the gestation period, the greater the pressure exerted by the growing uterus on the intestines and other organs. As a result, blood circulation in the vascular system of the small pelvis is disrupted and slows down, which can affect peristalsis.
• A large amount of progesterone in the blood relaxes the smooth muscles of not only the uterus, but also the intestines. However, this is the cause, rather than the spasm, of intestinal atony.
• During pregnancy, most women become emotionally unstable. They are easily irritated, and unreasonable fears and worries appear. This is due to hormonal changes in the body. However, a side effect of this condition can be neurogenic constipation, which goes away on its own after the woman's mental state stabilizes.
• Less common causes of spasm include allergic reactions of the body or food poisoning.

It is not advisable to take laxatives without a doctor's prescription during pregnancy; you should consult a specialist.

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Spastic constipation in a child

Intestinal spasms in small children may occur as a result of changes in nutrition, for example, when switching to artificial feeding, or when introducing new complementary foods. The cause may also be an incompletely formed nervous system, which causes the same neurogenic constipation.

In older children, spastic conditions may arise as a result of eating too many sweets, not drinking enough fluids, or eating dry food. Sometimes, spasms are the result of stress – moving to a new area, transferring to a different school, etc.

Spastic conditions in childhood can occur in every third child. Treatment is prescribed by a doctor depending on the cause of the disease, but therapy with antispasmodic drugs is rarely used. Most often, a short course of treatment with rectal suppositories with laxative and relaxing properties is sufficient.

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Diagnosis of spastic constipation

The diagnosis can only be made by a specialist – a proctologist, gastroenterologist-infectious disease specialist or therapist, based on the results of the examination.

The examination may include:

• rectoscopy – a procedure for examining the rectum and lower sigmoid colon using a special device – a rectoscope;
• irrigoscopy – an X-ray technique that involves the introduction of a contrast agent into the intestine;
• fibrocolonoscopy – endoscopic examination of the intestinal cavity.

The listed studies are very important in order to assess the condition of the mucous tissues of the intestinal cavity, the degree of peristalsis, the elasticity of the intestine, and the functionality of the intestine as a whole.

Sometimes a stool analysis is performed for microflora, since a lack of lactic acid fermentation bacteria can lead to putrefactive fermentation, which directly affects the development of problems with intestinal function.

Objectively, the doctor can determine pain in various parts of the intestine by palpation. In addition, the compressed flagellate sigmoid colon is clearly felt, while the cecum is assessed as relaxed.

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Treatment of spastic constipation

Restoring normal peristalsis of the digestive system is task No. 1 in the treatment of spastic intestinal conditions. Treatment should be comprehensive and include several therapeutic stages:

• dietary nutrition (we will talk about it separately);
• drug therapy;
• taking homeopathic remedies;
• folk remedies.

If there is such a problem as a bowel movement disorder, then it is necessary to get rid of it, as with any other pathology, starting with a doctor's consultation. A timely correct diagnosis makes the treatment more effective and faster.

If for some reason the visit to the doctor is delayed, then at first you can try to cope on your own, but in the future visiting the doctor should become mandatory. We will try to answer some questions of patients that most often arise when treating intestinal spasms.

Does an enema help with spastic constipation?

• Indeed, a cleansing enema is often used for difficulties with defecation. But it is important to know that in case of spasms, a cool solution should not be administered, as this can increase the spastic contraction of the muscles. The temperature of a cleansing enema for spastic constipation should be moderate: the liquid is heated to body temperature (approximately 36-39°C) and introduced into the intestines without pressure, carefully. You can make a relaxing solution, for example, with a decoction of lemon balm or mint (200 ml). However, oil enemas are considered more effective, for which oil heated to a temperature of 30-32°C, with a volume of 200 ml, or an oil-water mixture with a volume of about 500 ml, is used. Castor, sunflower, and olive oils are most often used.

Can you take a laxative for spastic constipation?

• Laxatives for intestinal spasms should be chosen very, very carefully, stopping only at those products that consist of herbal ingredients. If possible, it is better to do without laxatives altogether. Why? The fact is that the vast majority of such medications stimulate intestinal peristalsis, which can aggravate an existing spasm and worsen the patient's condition. The difficulty is that it is impossible to increase the motility of an already spasmodically contracted intestine without having an idea of why this spasm occurred. Therefore, taking a laxative in such a state, the patient risks increasing pain and aggravating the problem up to spastic intestinal obstruction.

If taking a laxative for spasms is unavoidable, then you can resort to a complex intake of medications. For example, the well-known Duphalac for spastic constipation is prescribed simultaneously with antispasmodic drugs. Only in this case can the patient's condition be alleviated and the problem with defecation be solved.

Which antispasmodics are most effective for spastic constipation?

• Antispasmodic drugs for the intestines are divided into several groups and have some limitations for use. Therefore, you should not use them without consulting a doctor.

The main and most common intestinal antispasmodic is Papaverine - it can be purchased in tablets, injection solution and rectal suppositories. In everyday life, suppositories with papaverine are most often used - they perfectly relax the intestinal muscles, eliminating spasms and restoring the evacuation function. Papaverine tablets are taken 1 piece no more than 4 per day.

In the absence of Papaverine, you can take antispasmodics such as No-shpa (Drotaverine) or Dibazol, which is also a peripheral vasodilator.

Dibazol for spastic constipation can be used in injections or tablets. Injections of the drug are administered intramuscularly, 1-2 ml of 1% solution, up to 2-3 times a day, as needed. Tablets are taken in an amount of no more than 50 mg at a time and no more than 150 mg per day.

A popular drug is Papazol, a combination drug based on Papaverine and Dibazol.

Is it possible to treat spastic constipation at home?

• Of course, in any case, a preliminary consultation with a doctor is desirable. The patient will not be able to determine the cause of the spasm on his own. In simple situations, it is quite possible to cope with treatment at home, but the regimen for taking medications should be competent and consistent: first antispasmodics, and then (if necessary) laxatives. If there is inflammation, then anti-inflammatory treatment, restoration of intestinal microflora, and general strengthening of the body will be required. Warm baths, abdominal massage, and taking mild sedatives give a good effect. Enzyme preparations are also recommended, for example, Mezim, Enzistal. In some cases, folk methods of therapy may also be relevant.

Folk remedies for spastic constipation

There are a large number of folk recipes that can be successfully prepared at home. It is enough to have certain prepared plants at home, or buy them in dry form at the pharmacy.

• Pour 200 ml of boiled hot water over 1 teaspoon of mint leaves, cover with a lid and leave for a quarter of an hour. Drink the infusion after meals at least twice a day.
• Pour 300 ml of boiling water over 3 tablespoons of wild flax (flaxseed), you can use a thermos. Leave to brew for half an hour. Take the filtered infusion 60 ml 3-4 times a day.
• Prepare a mixture of 20 g of horsetail, the same amount of yarrow, 10 g of wormwood, pour 400-500 ml of boiling water, leave for 2 hours (preferably in a thermos). Filter the finished infusion and drink 100 ml 3-4 times a day with food.
• An infusion of dill or fennel is good for relieving spasms. Take 1 tablespoon of seeds and pour 200 ml of boiling water over it, leave for a quarter of an hour. Take 100 ml during spasms.
• Mix 15 g of dry plantain leaf, the same amount of sage, 5 g of mint leaf, 10 g of marsh cudweed and 15 g of St. John's wort. Brew one teaspoon of the resulting mixture in a glass of boiling water and leave for half an hour. Drink three times a day, 1/3 of a glass.

In addition, you can also use the following herbal mixtures:

• buckthorn bark, fennel seeds, buckthorn, licorice rhizome;
• senna leaf, buckthorn bark, buckthorn, anise, licorice rhizome;
• St. John's wort herb, marsh cinquefoil leaf, tansy herb, valerian root, calamus rhizome;
• anise, fennel, cumin, mint leaf.

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Diet for spastic constipation

In case of intestinal spasms, it is necessary to exclude coarse food from the diet, which irritates the intestinal walls. For this reason, experts advise eating plant foods rich in fiber, but without the peel and preferably in a mashed state.

A major role in bowel movements associated with spasms is played by the consumption of fats, sour cream, and natural butter - these products can alleviate the manifestation of muscle spasms.

In addition, vegetable and fruit dishes should be consumed boiled, and sugar or honey can be added to them.

Products recommended for intestinal spasms with constipation:

• vegetable soup, meat broth, fruit soup;
• dairy products and dairy dishes (except hard or processed cheese);
• boiled meat and fish;
• dark breads, cereals, whole grain pasta, dry biscuits or crackers, bee products, homemade jam, marshmallows, marmalade, sugar;
• vegetable and butter oils, cream;
• pureed and boiled vegetables, greens;
• fruits (except cherries, citrus fruits, blueberries);
• tea, rosehip infusion, fresh juices, compotes.

Foods to avoid:

• lard, fatty meat;
• white bread, sweet bakery products;
• puff pastry;
• smoked products, sausages;
• conservation;
• legumes;
• dishes based on white cabbage;
• sauces with spices and fats;
• from cereals - rice and semolina;
• radish, horseradish, onion and garlic;
• mushroom dishes;
• cakes, pastries;
• chips, nuts;
• jelly, cocoa, carbonated drinks;
• chocolate products;
• hot spices;
• alcoholic beverages;
• pork, beef fat, lard.

You can't eat dry food or overeat. It's better to refrain from eating during spastic pains.

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Menu for spastic constipation

• Breakfast for intestinal spasms can consist of porridge with water or milk, fermented milk products, cottage cheese. You can add a piece of dark toasted bread with butter, honey or jam. Oatmeal with additives, for example, with apple pieces or banana, is perfect.
• For a second breakfast or snack, you can drink tea with dry biscuits, or prepare a fruit or berry mix with strawberries, peeled apricots, pumpkin. It is recommended to pour yogurt or sour cream over the berries.
• It is advisable to have lunch with a mandatory first course, which can be soup or borscht, without hot spices and seasonings. A piece of boiled meat or fish is suitable for the second course, you can cook them in a steamer, with or without a side dish. A great addition will be a mashed vegetable stew or a vegetable casserole.
• Cookies, berry smoothie, yogurt, cottage cheese with fruit or fruit puree are suitable as an afternoon snack.
• For dinner, you are allowed to prepare steamed cutlets, a vegetable side dish with dark bread, a vegetable omelet, and porridge with water.
• Before going to bed, it is useful to drink 100-150 ml of fresh kefir, natural yogurt or sour milk.

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Prevention of spastic constipation

Preventive measures include a short list of useful tips:

• if you are prone to intestinal stagnation, eliminate from your daily menu dishes and products that can provoke bowel movement disorders. These include fatty meats and lard, cakes, eggs, baked goods made from white flour, chocolate and cocoa products;
• do not forget to eat a little fruit, vegetables, and grains every day – foods with fiber and coarse indigestible fibers, from which feces are formed;
• If you are prone to spasms, try to avoid eating cold foods, including ice cream and cold drinks;
• Your enemy #1 is overeating, so get up from the table before you are completely full. Occasionally practice fasting days or 24-hour water fasts;
• Laxatives and antibiotic therapy should be used as rarely as possible and only as prescribed by a doctor;
• don't forget to maintain a drinking regime - drink clean water, fresh juices, fruit drinks;
• if you have the urge to defecate, do not suppress it or wait for it to pass – empty your bowels in time;
• lead an active lifestyle - constipation does not like physical activity, which has a positive effect on intestinal tone;
• Eat only fresh food. Spoiled or suspicious food should be thrown away.

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Prognosis of spastic constipation

The prognosis for bowel movements caused by intestinal spasms is very favorable. But in rare cases, the disease can result in a number of complications - the formation of fecal stones, the development of intestinal obstruction, fecal peritonitis. Such complications are most common in elderly people and bedridden paralyzed patients.

With timely treatment, the prognosis remains good.

Spastic constipation is an extremely unpleasant condition. However, timely treatment, including diet, bed rest during the acute period, the use of warm baths and a heating pad, will help to say goodbye to the disease within 5-7 days.

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