Atonic constipation - causes, symptoms, treatment

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26.08.2019

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The cause of the development of an allergic reaction in an adult is often a “lazy gut”. The body is not actively getting rid of toxins and wastes, since reduced intestinal motility does not ensure normal, stable elimination of waste products.

Causes of atonic constipation

The causes of atonic constipation include the following factors:

abnormalities of intestinal development;
diseases of the endocrine system, changes in hormone levels (during pregnancy, menopause, etc.);
neurological disorders;
spinal cord injuries;
taking medications that affect intestinal motility.

The cause of atonic constipation is a sedentary lifestyle. It is not necessary to have a sedentary job - atonic constipation also occurs after injuries and operations, when it is necessary to adhere to bed rest. Other possible causes include intoxication, exacerbation of inflammatory diseases, depression, bad habits, and infectious diseases.

A number of medications change muscle tone; antispasmodics, analgesics, antidepressants, some hormonal drugs, and medications that affect the transmission of nerve impulses can weaken it.

So-called idiopathic constipation has no known cause. Atonic constipation is often idiopathic in nature.

It is believed that intestinal dyskinesia is characteristic of functional constipation and irritable bowel syndrome with their predominance. But the slow movement of contents through the colon is associated with pathologies of the muscles and nervous system. There are two criteria by which an inert, or lazy, bowel is determined: resistance to laxatives and instrumental confirmation of slowing.

How to improve intestinal motility?

When drawing up an individual nutrition plan, the doctor takes into account the nature of the disease and peristalsis disorders, the presence or absence of intolerance to certain foods, age and even the patient’s taste preferences. However, there are general recommendations that can be used to speed up or, conversely, slow down intestinal motility.

How to speed up peristalsis during constipation?

In case of sluggish peristalsis, the patient is recommended:

Fiber-rich foods. It is not broken down in the gastrointestinal tract, but is used as a source of nutrition by intestinal bacteria, adsorbs and retains water, thereby helping to normalize stool consistency2,5.

Contains a large amount of fiber:

vegetables, especially beets and all types of raw cabbage;
fruits: apricots, blackberries, kiwis, apples and pears;
any greens;
products made from wholemeal flour and whole grains;
dried fruits such as dried apricots, prunes, figs, dates;
“coarse” cereals: buckwheat, oatmeal, barley, millet, pearl barley;
nuts: almonds, pistachios, peanuts (unsalted);
legumes2.5.

Doctors recommend eating 100-150 g of fiber-rich foods 2-3 times a day2.

Products containing organic acids: sour milk, yogurt, kefir, acidophilus, sour fruits and berries2.
Sweets containing mainly simple carbohydrates: honey, marshmallows, marshmallows, marmalade, caramels, preserves and jams, sweeteners, for example, fructose and sorbitol2.
Salty foods, pickles and marinades; in general, it is allowed to consume up to 12-15 g of salt per day.
Cold food and drinks2.
Carbonated mineral water containing carbon dioxide: cold on an empty stomach 1-1.5 hours before meals2.5.
If there are no contraindications (heart and kidney disease), you need to drink about 1.5-2 liters of liquid per day2.

You need to follow a proper diet, eat 5-6 times a day - this helps maintain normal intestinal motility2.

In addition to nutrition, it is important to maintain a high level of physical activity2,3,5. Afternoon walks in the fresh air act as an intestinal massage and promote the production of hormones that improve the functioning of the gastrointestinal tract5.

How to slow down intestinal motility?

To calm your irritated bowels a little and solve the problem of frequent bowel movements, you need to adhere to the following dietary recommendations:

Dishes made from carefully ground or pureed products are preferred: lean meat in the form of meatballs, quenelles and soufflés, liquid porridges (rice, Hercules, semolina), potato, vegetable and fruit purees, pureed soups, etc.
Eliminate foods that cause fermentation and rotting in the intestines: yeast bread and pastries, legumes, grapes, dairy products.
Avoid products containing essential oils: turnips, radishes, radishes, spinach, onions, garlic, mushrooms, etc.
All dishes and drinks must be warm (15-600 C).
Include tannin-rich foods in your diet: strong tea, persimmons, apples, blueberries, cherries, walnuts and cashews. They have an astringent effect and thicken stool2.

For drug correction of peristalsis disorders, traditional medicine uses prokinetics (stimulate contractions of intestinal smooth muscles), antispasmodics that relieve excessive smooth muscle tension, laxatives and antidiarrheals3,4. In each specific case, the doctor selects treatment individually. Among the drugs that help cope with diarrhea, loperamide preparations, including IMODIUM® Express7, occupy a special place. Loperamide has the ability to slow intestinal motility and reduce stool frequency4,5,8. You can use the drug on the recommendation of a doctor from 6 years of age7.

The information in this article is for reference only and does not replace professional advice from a doctor. To make a diagnosis and prescribe treatment, consult a qualified specialist.

Literature

Tkachenko B.I. Normal human physiology. Textbook for higher educational institutions // Medicine, 2005. - 928 pp., chapter 11.
Baranovsky Yu. A. Dietetics. Guide for doctors / Peter, 2008. — pp. 465-469.
Minushkin O. N. Functional constipation: recommendations for diagnosis and treatment // Regular issues of “Breast Cancer”. — No. 11 dated 06/30/2016. - pp. 703-707.
Cheremushkin S.V., Kucheryavyi Yu.A. Functional diarrhea. Rome criteria IV // Experimental and clinical gastroenterology. — 2022. — issue 139. — No. 3 –– pp. 84-88.
I. V. Mayev. Chronic constipation // Attending physician. - 2001. - No. 7.
S. V. Belmer, T. V. Gasilina. Motility disorders of the digestive organs and general principles of their correction // Attending physician. - 2010. - No. 7. - pp. 12-16.
Instructions for use of the drug IMODIUM® Express.
Register of medicines in Russia. Active ingredients. Loperamide.

Symptoms of atonic constipation

Symptoms include bloating, flatulence, abdominal pain, intestinal colic, and absence of intermediate urges between bowel movements. Researchers Shulpekova and Ivashkin in their scientific work indicate that “hypotonic or atonic functional constipation is associated with loss of tone of the colon. In this case, the delay in defecation can reach 5–7 days, the feces can be large in volume and loose in consistency” (Shulpekova, Ivashkin, 2004, p. 49).

However, this does not mean that dry and dense, fragmented feces cannot be observed. Stagnation of feces leads to the absorption of water from them, as a result of which the consistency of the stool changes. Often the act of defecation is accompanied by severe pain.

The characteristic symptoms of atonic constipation include the following:

Bloating, flatulence. They develop against the background of stagnation of feces and excessive absorption of water from them.
Pain in different parts of the abdomen. Often associated with gas formation, they can resemble intestinal colic - they appear periodically, without clear localization.
Absence of intermediate urges between acts of defecation.
Pain in the rectum. From time to time, due to overstretching of the rectal ampulla, cramping pain may occur.

There is a high probability of developing proctological complications, so blood and mucus are often present in the stool. If such symptoms occur, you should consult a doctor immediately.

Other symptoms are associated with general intoxication of the body with feces. Increased absorption of toxins in the colon leads to fatigue, pale skin, sweating, dizziness, decreased appetite, and nausea. These are nonspecific manifestations of poisoning, so they can persist for many years, and the person simply has no idea what is causing this feeling.

Causes of the development of “lazy bowel” syndrome

In addition to a sedentary lifestyle, the following can lead to decreased peristalsis:

lack of daily fluid intake, which causes the stool to become too dry and hard, making it difficult to pass;
lack of fiber, which naturally stimulates peristalsis;
excessive consumption of high-calorie and refined foods - white bread, processed rice, fatty sausage and cheese, as well as coffee and cocoa;
taking certain medications, the side effect of which is a decrease in peristaltic activity - antidepressants and painkillers;
increased progesterone levels during pregnancy;
inflammatory process of the gastrointestinal tract.

The consequences of these problems are frequent constipation, flatulence, and a feeling of heaviness in the stomach.

Complications of constipation

Atonic constipation, like other types of bowel movement disorders, can lead to serious complications. In the long term, they affect the health of the cardiovascular system, increase the risk of strokes and heart attacks, malignant intestinal tumors, reduce resistance to infections, and stimulate the exacerbation of allergic diseases.

Complications such as hemorrhoids, anal fissures, proctitis and paraproctitis can occur even against the background of one episode of constipation if there is a predisposition.

Quite quickly, against the background of prolonged constipation, dysbiosis develops - a change in the balance of intestinal microflora can further aggravate the problem, lead to a deficiency of vitamins and minerals, and a general weakening of the body. Therefore, it is important to consult a doctor in a timely manner to correct the problem.

What can you do at home?

You should start with massage and physical therapy techniques . This stimulates intestinal peristalsis. Place your baby on his tummy before feeding. The massage is also carried out before feeding: circular movements on the tummy in a clockwise direction are recommended. After the “meal”, do not put the child to bed immediately - hold him in what is called a “column”, that is, vertically. There is no need to throw it in the palm of your hand, as many people do, as it can provoke a burp. To stimulate the intestines and the release of gases, straighten your baby's legs and at the same time bend them towards the tummy. Repeat 10-15 times, pressing firmly onto the area below the ribs. Then do the same, but with each leg separately. If the baby holds his head well, take it under your knees and hold it over the diaper or toilet.

Have you already introduced complementary foods into your child's diet? This may help combat constipation. Carrots, zucchini, pumpkin are natural laxatives . But mashed potatoes and cereals are not suitable in such cases, they “fix” the intestines. Suitable as a laxative are dried apricots, as well as prunes, but only from 5 months of age. Stimulation of the anus is effective in the fight against constipation. Insert a cotton swab lubricated with Vaseline , but shallowly, 1 cm, and carefully rotate. gas tubes help with constipation and colic. They are inserted to a depth of no more than 3 cm. There is an opinion that frequent use of tubes is addictive. Some people agree with this statement and others do not, but experts recommend not to abuse them.

Features of treatment

Treatment of atonic constipation is complex. There are several approaches to drug therapy: +

motility regulators, enterokinetics, and other agents. They allow you to regulate intestinal motility by correcting the tone of the intestinal muscles.
Drugs that indirectly affect the digestive system. This approach is used when atony is caused by other diseases. Medication support and correction can improve bowel function.
Symptomatic therapy: laxatives for immediate relief, medications to eliminate symptoms of intoxication, painkillers. Such remedies complement the main course of treatment or other measures to normalize intestinal function.

It should be understood that basic and symptomatic treatment should be prescribed by a specialist. One of the main mistakes many people make is trying to help themselves with symptomatic treatment, laxatives or cleansing enemas, without undergoing examinations. Why is this an error? The choice of laxative should take into account the option of chronic constipation.

Doctors try not to prescribe laxatives that chemically stimulate peristalsis. Parfenov V.I. in his article explains why “the main disadvantage of the listed laxatives is the rather rapid addiction to them, the need to gradually increase the dose, significantly exceeding the permissible, and, as a consequence, degeneration of the mechanoreceptors of the colon” (Parfenov, 2013, p. 100 ).

But not only chemical laxatives can be addictive when taken over a long period of time. You should be especially careful with any senna-based laxatives, as prolonged use leads to addiction and the need to constantly increase the dosage to achieve a positive effect.

Regular use of cleansing enemas will also lead to the appearance of an inert colon - a lack of urge to defecate and worsening the problem.

Laxatives, which increase the volume of intestinal contents and osmotic pressure, are not addictive and can be used for constipation. But many patients require discontinuation of treatment due to bloating, painful cramps and other possible side effects.

Principles of effective treatment:

competent selection of laxatives in accordance with the type of constipation;
refusal of self-medication;
following doctor's orders.

One of the non-addictive laxatives is Fitomucil Norm. It contains soluble and insoluble dietary fiber - the shell of psyllium seeds and the pulp of homemade plum fruits. The English drug acts gently and predictably, helping to restore normal stool. "Fitomucil Norm" does not cause side effects in the form of spasms, pain, false and repeated urges to defecate. Psyllium absorbs water, turning into a gel, which allows you to gently remove feces. Insoluble fiber stimulates intestinal motility. Long-term use of the drug is allowed in consultation with a doctor.

Symptoms and treatment of atonic constipation are always strictly individual: it is important to determine the cause of the disorder and correct it. To do this, the doctor will prescribe a comprehensive diagnosis. You may need to consult other specialists: endocrinologist, neurologist.

Constipation in pregnant and lactating women

Due to hormonal changes in the body of pregnant women, as well as against the background of compression of intestinal loops by the growing fetus during the period of bearing a child, and then during feeding, constipation often appears.

Meanwhile, many laxatives are contraindicated for pregnant and lactating women. Changing your diet and increasing physical activity (within permitted limits) also do not always give a positive result.

For treatment at home and during a stay in the maternity hospital, pregnant women can use MICROLAX®, which is suitable for both the expectant mother and the child. It can be used for a long time, so it is also suitable for combating chronic constipation in pregnant women.

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Treatment of medicinal constipation

Atonic constipation may be associated with medications. This effect occurs not only with an overdose, but also as a side effect. We are talking about narcotic analgesics, anticholinergics, hormonal drugs, drugs for normalizing blood pressure, iron supplements, antidepressants, etc.

In some cases, it is advisable to choose an alternative and adjust the treatment regimen for the underlying disease in order to prevent the development of complications from the digestive system. But this should only be done by a doctor.

Therefore, contact a specialist and tell them about the medications you are constantly taking and the associated atonic constipation: he will definitely provide qualified assistance and give recommendations.

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Diagnosis of digestive tract problems

Dysbiosis can cause lazy bowel syndrome.

Lazy bowel syndrome doesn't come out of nowhere. It manifests itself as a consequence of some disease. For example:

Parkinsonism
Abdominal circulation problems
Problems with blood circulation in the pelvic area
Hypothyroidism
Diseases of the digestive organs
Dysbacteriosis
Hormonal disbalance
Lack of fluid in the body
Drinking hot drinks during meals
Unbalanced diet
Lack of active lifestyle

Only a doctor can make your sick intestines work. Without his help, all efforts will be in vain. Moreover, self-medication does not bring any good.

You cannot waste time on guesswork, because it is possible that these symptoms do not indicate a disease of the intestines or digestive system. To do this, you need to undergo an examination, on the basis of which your attending physician will make an accurate diagnosis and prescribe treatment.

If you follow all the doctor’s recommendations, eliminating lazy bowel syndrome will pass without any problems. It is quite possible that you will get away with just taking several medications, combining them with treatment with folk remedies.

But keep in mind that you should not use folk remedies on the advice of a neighbor, because... Not all medications can interact with folk remedies. Treatment should be carried out only as directed by the doctor!

Lifestyle correction

The treatment strategy for atonic constipation is as follows:

regulation of stool with the help of dietary fiber and water regime (at least 1.5 liters of clean water per day);
restoration of the lost morning defecation reflex, that is, the habit of emptying the intestines after breakfast;
maintaining physical activity.

Doctors pay great attention to the psychological state and mood. For example, researchers Marinchuk A. T., Bogatyrev V. G. and others in their work focus on “the need to live with daily morning stool” (Marinchuk, Bogatyrev, Babieva, Koumbatiadis, 2012, p. 53).

You should adjust your daily routine so that going to the toilet in the morning does not become a problem. It is advisable to get up earlier, provide conditions without haste, so that you do not have to restrain the urge.

What causes defecation disorders?

Most often, constipation in infants is functional, that is, acquired (almost 90%). Arise due to lack of milk and improper diet of the nursing mother; with early transfer of a child to artificial formulas and a sudden change from one formula to another; in cases of drinking violations; in case of allergic reactions to components of milk or formula (for example, to cow's milk protein); malfunction of the thyroid gland; iron deficiency. Among the reasons we will also name dysbacteriosis, immaturity of the gastrointestinal tract and the baby’s central nervous system. The cause of bowel problems is often lactase deficiency - a deficiency of lactase, the enzyme that breaks down milk sugar (lactose). As a result, difficulties arise with the absorption of breast milk.

At the same time, constipation in infants can be organic, that is, congenital . They, as a rule, torment the baby from the very first days of life and are associated with various developmental anomalies. We can talk about narrowing the intestine and lengthening its section; intestinal infections; disturbance of intestinal motility due to weakness of its muscles; rickets (lack of vitamins D); cystic fibrosis; Down's disease; hypothyroidism; Hirschsprung's disease. Often, so-called organic constipation is provoked by various birth injuries. The reasons for delayed bowel movements sometimes lie in the gallbladder. For a number of reasons (both congenital and acquired), it may not work correctly, which leads to digestive disorders in infants.

Exercise and physical activity

It is important to increase physical activity: make it a habit to take morning and evening walks, jogging, play sports to the extent physically possible, and swim. If atonic constipation is the result of an injury or a disease of the musculoskeletal system that requires long-term immobilization, then it is important to consult a doctor.

The specialist will develop an exercise program individually, taking into account capabilities and general health. Constant bed rest and complete abstinence from exercise are not indicated in almost any case, except for the most severe ones, so movement is a necessary component of improving the functioning of the gastrointestinal tract.

Exercises such as “bicycle”, leg lifts, and walking are useful. If it is impossible to perform the exercises, you should resort to a kind of passive activity - do a light abdominal massage. Movements should be soft, careful, clockwise.

Treatment complex for constipation

This set of exercises should be done even before getting out of bed:

Star. Get into a star position with your arms and legs out to your sides. Next, pull your knees as close to your chest as possible. Wrap your arms around it. Make an effort to touch them with your forehead. Then take the starting position.
Body work. After the Asterisk exercise, you should relax, while lying on your back. Next, without moving your legs, lift your body with an inclination on each leg.
Scope. While still lying in bed, you can roll over onto your stomach and get on all fours, and swing your legs one at a time.
Squat. Get out of bed and do squats for 15 minutes. But keep in mind that you need to do this exercise slowly!!! This needs to be emphasized.
Body turns. You need to stand up straight and straighten your arms to your sides. Perform body turns using the muscles of the back and lower back, as well as the abs.

These physical exercises will help launch the intestines.

Nutrition/diet

Meals should include foods rich in plant fiber and contain fermented milk products. There should be more plant foods than animal products. This will help improve the functioning of the digestive tract, increase the volume and facilitate the excretion of feces. Bran is useful - separately or as part of special bread. These are natural laxatives, just like vegetable oils.

But you should remember: bran is a source of insoluble dietary fiber, the consumption of which in large quantities can provoke increased constipation and increased gas formation. If you are prone to constipation, it is better to pay attention to products containing predominantly soluble dietary fiber.

From the diet you need to exclude foods that thicken the stool and cause increased gas formation:

potato;
legumes;
white bread, pastries;
spicy dishes;
smoked meats;
canned food and marinades;
chocolate;
crackers;
peeled rice, etc.

The daily menu can be based on lean meats, poultry, fish, cereals (except rice and semolina), vegetables, and it is better to steam them. Can be used boiled. Dried fruits have proven themselves to be excellent, especially dried apricots, prunes, and raisins. You can use them on their own or make compotes from them.

Try to limit yourself to six grams of salt per day, otherwise the likelihood of developing fluid retention increases, and swelling is often accompanied by constipation.

It is important to consult a doctor first, especially for people with chronic diseases. The specialist will give precise recommendations regarding the diet.

Folk remedies to speed up the metabolic process

Carrot juice is a folk remedy for speeding up metabolism.

It is quite possible to speed up metabolism using folk remedies. It is enough to add 1 tsp to 1 glass of kefir. vegetable oil and drink it daily before bed.

Freshly squeezed carrot juice can be used as a mild laxative.
Green tea also opens up the intestines. It should be consumed before meals during the day. Dosage: 1 dose/0.5 tsp. green tea (in powder form).
You can eliminate congestion in the intestines with the help of infusions of nettle, chamomile, yarrow and even hay.

Fresh aloe juice is also used in alternative medicine. This method of accelerating metabolism is no less effective than any other method. It is noteworthy that it is more pleasant to consume aloe juice when diluted with honey.