Spastic constipation

Intestinal function may be impaired for various reasons. As a rule, its normal emptying is associated with two states - it is atony or spastic constipation. In this article we will talk about the second option - the occurrence of intestinal spasms, due to which constipation develops.

[1], [2], [3], [4]

Causes of spastic constipation

Constipation caused by spasm of the intestines, resulting from an increase in intestinal tone.

• Muscle spasms appear in separate intestinal segments, as a result of which the feces are clamped and lose the opportunity for further advancement.
• The spasm is often accompanied by flatulence, spastic pains and a feeling of heaviness and overcrowding in the abdomen, which is associated with increased gas formation.

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

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

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

[5]

Symptoms of spastic constipation

For intestinal spasm is characteristic when the delay of defecation does not occur all the time, but periodically. Between the constipation, the stool may look normal or even liquefied. You can often observe situations that can be compared with mild diarrhea - this is the result of the body's response to prolonged stagnation of the feces and muscle spasm. In most cases, this occurs when the spasm is associated with nervous disorders.

Clinically, intestinal spasm is manifested by irritable bowel syndrome, which can be expressed in the following symptoms:

• abdominal tenderness, often cramping;
• periodic delay of defecation;
• output along with the feces of mucus particles;
• increased emotionality and irritability;
• constant feeling of tiredness.

Sometimes the delay in stool may be insignificant, however, the excretion of feces while incomplete, small elements. After such a bowel movement there is a feeling of incomplete intestinal emptying, heaviness in the stomach, unjustified satiety.

[6]

Spastic constipation during pregnancy

About 70-80% of women complain of problems with defecation during pregnancy, as well as about 30% in the postpartum period. At this time, atonic constipation associated with the inactivity of intestinal peristalsis may be more frequently disturbed. However, intestinal spasms in pregnant women are not uncommon.

Regarding how to distinguish spastic constipation from atonic, we can say the following:

• intestinal atony is the absence of peristalsis, which may be due to relaxation of the smooth muscles of the intestines, lack of fiber in the diet and for other reasons. In case of atony, the intestine is “silent”, there is no desire to have a bowel movement;
• the spastic condition of the intestine is usually accompanied by increasing and temporarily relieving pain, rumbling in the abdomen, increased gas formation and an irregular stool (constipation can be replaced by diarrhea).

What causes a stool delay?

• The longer the gestation period, the greater the pressure the growing womb has on the intestines and other organs. As a result, the blood circulation in the vascular system of the pelvis is disturbed and slows down, which can affect peristalsis.
• A large amount of progesterone in the blood relaxes the smooth muscles not only of the uterus, but also of the intestines. However, this reason, rather, not spasm, and intestinal atony.
• During pregnancy, most women become emotionally unstable. They are easily irritated, causeless fears, experiences appear. This is due to hormonal changes in the body. However, a side effect of this condition can be neurogenic constipation, which disappears on its own after stabilization of a woman’s mental state.
• Allergic reactions of the body or food poisoning are considered to be less frequent causes of spasm.

It is undesirable to take laxatives without a prescription during the period of carrying the child; you should consult with a specialist.

[7], [8], [9], [10]

Spastic constipation in a child

Intestinal spasms in young children may appear as a result of changes in the diet, for example, when switching to artificial feeding, or when introducing a new feeding. The cause may also be an unproduced nervous system, which causes the same neurogenic constipation.

In older children, the spasmodic condition may occur due to the consumption of a large amount of sweets, inadequate intake of liquid, and a dry meal. Sometimes a spasm is the result of stress - moving to a new area, moving to another school, etc.

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

[11], [12], [13]

Diagnosis of spastic constipation

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

The survey may include:

• sigmoidoscopy - a procedure for examining the rectum and lower part of the sigmoid colon with the help of a special device - the sigmoidoscope;
• irrigoscopy - X-ray technique, which involves the introduction into the intestine of a contrast agent;
• fibrocolonoscopy - endoscopic examination of the intestinal cavity.

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

Sometimes fecal masses are analyzed for microflora, because of the lack of bacteria in lactic fermentation, putrefactive fermentation may occur, which directly affects the development of problems with intestinal function.

Objectively, when feeling, the doctor can determine pain in various parts of the intestine. In addition, the squeezed harness of the sigmoid colon is well felt, while the cecum is assessed as relaxed.

[14], [15], [16]

Spastic constipation treatment

To restore the normal peristalsis of the digestive system is the number one task in the treatment of spastic bowel conditions. Treatment should be complex and include several therapeutic steps:

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

If there is such a problem as a violation of defecation, then you need to get rid of it, like any other pathology, starting with the advice of a doctor. Timely correct diagnosis makes treatment more efficient and faster.

If for some reason the appeal to the doctor is delayed, then at first you can try to cope on your own, but in the future visiting the doctor should be mandatory. We will try to answer some questions from patients who most often arise in the treatment of intestinal spasms.

Does the enema help with spastic constipation?

• Indeed, cleansing enema is often used for difficulty defecation. But you need to know that when spasms do not use the introduction of a cool solution, as this can enhance the spastic contraction of the muscles. The temperature of the cleansing enema for spastic constipation should be moderate: the liquid is heated to body temperature (approximately 36-39 ° C) and injected into the intestine without pressure, gently. 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 an oil heated to a temperature of 30-32 ° C is used, with a volume of 200 ml, or an oil-water mixture with a volume of about 500 ml. Most often use castor, sunflower, olive oil.

Can laxatives be taken with spastic constipation?

• Laxatives for intestinal cramps need to be chosen very, very carefully, stopping only on those tools that consist of herbal ingredients. If possible, it is better to do without laxatives at all. Why? The fact is that the vast majority of such medicines stimulate the intestinal motility, which can aggravate the existing spasm and worsen the patient's condition. The difficulty lies in the fact that it is impossible to increase the motility of an already spasticly reduced intestine, having no idea why this spasm occurred. Therefore, while taking a laxative in this state, the patient risks increasing pain and aggravating the problem, even spastic intestinal obstruction.

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

What are the most effective antispasmodics for spastic constipation?

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

Papaverine is considered the main and most common intestinal antispasmodic - it can be purchased in pills, injectable solution and rectal suppositories. In everyday life, suppositories with papaverine are used more often - they perfectly relax the muscles of the intestines, eliminating spasm and restoring evacuation function. Papaverine tablets take 1 pc. No more than 4 per day.

In the absence of Papaverine, you can take antispasmodics such as No-spa (Drotaverine) or Dibazol, which, moreover, is 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 necessary. Tablets take in an amount of not more than 50 mg at a time and not more than 150 mg per day.

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

Is it possible to treat spastic constipation at home?

• Of course, in any case, prior consultation with a physician is desirable. The patient alone will not be able to determine the cause of the spasm. In simple situations, it is possible to cope with treatment at home, but the regimen of medication should be competent and consistent: first, antispasmodics, and only then (if necessary) - laxatives. If there is inflammation, anti-inflammatory treatment, restoration of intestinal microflora, and general strengthening of the body will be required. Good effect is given by warm baths, massage of the abdomen, intake of light sedatives. Enzyme preparations are also recommended, for example, Mezim, Enzistal. In some cases, alternative therapies may be relevant.

[17]

Alternative remedies for spastic constipation

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

• Fill 200 ml of boiled hot water 1 tsp. Mint leaves, cover with a lid and insist a quarter of an hour. We use the infusion after meals at least twice a day.
• Fill with 300 ml of boiling water 3 tbsp. Spoons of wild flax (flax), can be in a thermos. Leave to brew for half an hour. Take filtered infusion 60 ml 3-4 times a day.
• Prepare a mixture of 20 g of horsetail, the same yarrow, 10 g of wormwood, pour 400-500 ml of boiling water, insist 2 hours (preferably in a thermos). Ready infusion filter and drink 100 ml 3-4 times a day with food.
• Well relieves spasm infusion of dill or fennel. Take 1 tbsp. Spoonful of seeds and pour 200 ml of boiling water, insist a quarter of an hour. Take 100 ml during spasms.
• Mix 15 g of a dry leaf of the plantain, the same amount of sage, 5 g of mint leaf, 10 g of dried marsh and 15 g of hypericum. Brew one teaspoon of the mixture obtained in a glass of boiling water and leave for half an hour. We drink three times a day for 1/3 cup.

In addition, the following herbs can be used:

• buckthorn bark, fennel seeds, zhoster laxative, licorice rhizome;
• senna leaf, buckthorn bark, zhoster laxative, anise, licorice rhizome;
• Hypericum herb, watch leaf, tansy herb, valerian root, calamus rhizome;
• anise, fennel, cumin, mint leaf.

[18], [19]

Diet for spastic constipation

When spasms of the intestine should be excluded from the diet of coarse food, irritating the walls of the intestines. For this reason, experts advise to eat vegetable foods rich in fiber, but without the peel, and preferably in a shabby state.

A major role in defecation disorders associated with spasms is played by the consumption of fats, sour cream, natural butter - these products can soften the manifestation of muscle spasms.

In addition, vegetable and fruit dishes should be used in boiled form, you can add sugar or honey to them.

Products recommended for bowel spasms with constipation:

• soup with vegetables, broth, fruit soup;
• dairy products and dairy dishes (except hard or processed cheese);
• boiled meat and fish;
• dark breads, cereals, whole-grain pasta, dry galetnye cookies or cracker, bee products, homemade jam, marshmallows, marmalade, sugar;
• vegetable and butter, cream;
• vegetables in the wiped and boiled form, greens;
• fruits (except cherry, citrus, blueberry);
• tea, dogrose infusion, fresh juices, compotes.

Products to exclude:

• fat, fatty meat;
• white bread, buns;
• puff pastries;
• smoked products, sausages;
• conservation;
• legumes;
• white cabbage-based dishes;
• 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;
• products with chocolate;
• spicy seasonings;
• alcoholic drinks;
• pork, beef fat, lard.

You can not eat a dry meal, overeat. During spastic pains, it is better to refrain from eating.

[20], [21]

Menu for spastic constipation

• Breakfast with intestinal spasms may consist of porridges on water or milk, from fermented milk products, cottage cheese. You can add a slice of dark dried bread with butter, honey or jam. Excellent oatmeal with additives, for example, with slices of apple or banana.
• As a second breakfast, or a snack, you can drink tea with dry biscuits, or make a fruit or berry mix with strawberries, apricots, without peel, pumpkin. Berries are recommended to fill with yogurt or sour cream.
• It is desirable to have dinner with the obligatory first course, which can be soup or borsch, without hot spices and seasonings. On the second, a piece of boiled meat or fish will do; you can cook them in a double boiler, with or without a side dish. An excellent addition will be shredded vegetable stews, or vegetable casserole.
• Cookies, berry smoothies, yoghurt, cottage cheese with fruit or fruit puree are suitable as an afternoon snack.
• For dinner it is allowed to cook steam cutlets, vegetable garnish with dark bread, vegetable omelet, porridge on the water.
• At bedtime, it is useful to drink 100-150 ml of fresh kefir, natural yogurt or sour milk.

[22], [23], [24], [25]

Prevention of spastic constipation

Preventive measures include a small list of helpful tips:

• If you have a tendency to intestinal stasis, cross out from the daily menu dishes and foods that can cause a violation of bowel movements. This is fatty meat and lard, cakes, eggs, white flour cakes, chocolate and cocoa products;
• Do not forget to eat daily a little of fruits, vegetables, cereals - products with fiber and coarse indigestible fibers, from which fecal masses are formed;
• with a tendency to spasms, try not to eat cold foods, including ice cream and cold drinks;
• your enemy number 1 is overeating, so get up from the table before you get full. Occasionally practice fasting days or daily water starvation;
• laxatives and antibiotic therapy should be used as little as possible and only as prescribed by a doctor;
• do not forget to maintain drinking mode - drink clean water, fresh juices, fruit drinks;
• when urging to defecate, it is not necessary to suppress or wait for them - release the intestines in time;
• lead an active lifestyle - constipation does not like physical activity, which has a positive effect on intestinal tone;
• eat only fresh food. Damaged or suspicious products must be discarded.

[26], [27]

Prognosis of spastic constipation

The prognosis for defecation disorders 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 for elderly people and paralyzed bed patients.

With timely treatment, the prognosis remains good.

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

[28], [29], [30]