Looking at this picture, many would smile, but a good chunk of people, they might reflect and find each other. It is estimated that the problem "STISPI" belongs to the 10-15% of the general adult population and 3-10% of the pediatric population! (American College Gastroenterology Crhonic Costipation Task Force 2005) But who defines styptic? Over the years, many of whom were the definitions, as u n inadequate number of bowel movements per week (less than 2-3 times a week)
But the definition which, in my humble opinion, this is good clinical picture is Prof. Bazzocchi:
"Constipation is a symptom, a complaint which the patient's dissatisfaction with the evacuation."
And I might add a footnote to this definition: " which is also reflected strongly in the quality of life of the patient"
Yet, patients often overestimate or underestimate or even the problem! It is therefore very important to understand
Who is the patient suffering from constipation? understand what he meant by that term. For a large number of individuals of no daily evacuation of stool from the patient is defined as constipation. (Ed I would say 70% of patients) But it is also true, especially in young women, in cases where the discharge is rare, is that every 4,6,8, even 20 days!
Because of this difficulty in framing the patient and the variability of the subjective perception of the problem, we tried to define the problem in an objective way, using certain criteria to better define the concept of constipation:
Presence of at least two of the following signs for at least three months, without taking laxatives:
"Excessive strain on defecation at least once in four;
'sensation of incomplete evacuation at least once four;
"Presence, small stools and / or hard at least once in four;
" Less than three bowel movements per week.
But what are the causes of so much suffering?
briefly analyze some typical picture:
- slow transit (diseases of the smooth muscle, nerve)
- obstructive syndromes (disorders of the anal canal) or pelvic floor disenergia
- IBS
Beware these organic causes are associated with other causes such as:
- Pregnancy
- medication
- central nervous system disorders
- transients
- improper diet
- no hydration
- electrolyte abnormalities
- Surgery
- immobilization
- thyroid dysfunction (hyper-active thyroid)
- Depression
short, the list is not complete, but as you will understand the causes varie.Un aspect can be just as assessed is taking medication. E 'is often underestimated, factor cocktail that many patients are developed.
non-steroidal anti-inflammatory drugs ( my friend Gregory consumes a tons) can cause constipation, as well as some antacids containing magnesium and aluminum, antidepressants, beta-blockers, diuretics, antiparchinsoniani etc etc. Without these That said, there is talk that the approach to the patient in terms of clinical and instrumental, but before intreprendere this way, I turn my attention to that patient population PURGE OFFICIALS!
It is to you, children of tea, plums, and decoctions of the bottle of laxative hidden in the cupboard!
In recent days, I responded to a request for consultation, which was received on my e-mail, which then prompted me to write and treatment of constipation do it yourself!
Few people know the effects of chronic purges! and as a joke can be the cause!
Warning! I refer to the proportion of patients who are scouring employee for many years!
I refer to "Melanie colic that IS NOT 'A Pre-cancerous! but a dark pigmentation that is detected during a colonoscopy examination it is reversible! (Just stop with the cathartic) often associated with the recruitment of the Seine (anthraquinone plants) or phenolphthalein. But at what
joke I was referring, parlanado of laxatives? The atonia
colic, or stop driving peristaltic wave, which just serves to bring out from our intetsino feces.
So, beware of the do-it-yourself therapy, often started by young women to lose that chiletto more quickly! Or the elderly patient, immobilized in bed without tea is not empty.
But back to the diagnosis of constipation. Colonoscopy NOT FIND NO INDICATION IN THE DIAGNOSIS OF CONSTIPATION, unless there is clinical suspicion of a morbid condition specisfica (search for polyps or colonic cancer).
weapons at our disposal are:
- Studio transit time
- defecography
- Manometry
This clinical-instrumental patterns, must always be preceded by an evaluation of colon-proctology and are considered sensitive and specific changes to the definition dele functional anatomy of the gastro-intestinal tract.
So before we talk about constipation ........ Wait a minute!
